Since the establishment of the Hospital Authority more than three decades ago, Hong Kong residents have, rightfully, enjoyed health services that are among the most affordable globally. Health outcomes – including life expectancy and mortality rates for acute illnesses – rank among the best in the world, often outpacing those in many developed nations.
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The Hospital Authority was founded on the principle that no one should be denied adequate medical treatment through lack of means, a noble mission that must be upheld. Rising healthcare costs and a budget deficit, however, are threatening this assertion. If we had not witnessed these challenges, the cost of hospital visits would not need to be revised today
Healthcare expenditure has been spiralling upwards globally over the past 20 years, underscoring the need for reform. In the United States, for instance, this led to then-president Barack Obama’s Affordable Care Act in 2010, which aimed to expand health coverage while reducing waste and inefficiencies in health services.
By pushing for a capitation payment system – with fixed fees for the entire coverage agreed upon in advance – instead of volume-based payments, the law forced healthcare providers to produce the best possible health outcomes without unnecessary expenditure, allowing successful institutions to retain excess funds.
In Hong Kong, government funding constitutes over 90 per cent of the Hospital Authority’s income, placing an untenable burden on taxpayers. For eight years, the authority shied away from adjusting hospital fees due to a lack of political will. While the Hospital Authority is not required to meet economic targets, this reluctance was unacceptable given that efficiency goals have languished at every level of the organisation.
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As health expenditures surge, it is irresponsible to ignore the ticking time bomb. And subventions – grants from the government – should not be seen as unlimited. Patients will always ask for more health services, yet they are shielded from the costs. For too long, overlooking the elephant in the room to prevent political fallout seems to have been the solution.
The Health Bureau stepping up to reform the fee schedule of public hospitals is commendable, not least because directing resources towards patients crippled by catastrophic illness is the essence of hospitals ab initio.