Hong Kong’s Health Care Reform: Nursing an Ailing Health Care System Back to Health

Hong Kong’s health care system needs reform. With a public sector facing overwhelming workloads and financial unsustainability and a private sector hit hard by Asia’s economic slump, government officials and citizens alike fear an impending health care crisis. The public health care sector is highly subsidized by the government, which is in turn supported by one of the lowest tax regimes in the world. (Granitsas, p. 1) A number of health care reforms have been proposed in the past ten years; and four years after the transition to China, it seems that Hong Kong can finally concentrate on revamping its health care system. This will be a slow and painful process, however, as the government and the public debate over everything from insurance schemes and medical fees to complaints offices and doctors’ guidelines. Three key reform proposals have been presented since 1999. First, a government-commissioned Harvard report entitled Improving Hong Kong’s Health Care System – Why and for Whom? was released in April 1999. (Health and Welfare Bureau, p. 2) Although the report accurately identified many of the most pressing issues facing the health care system, the proposals made by Harvard’s School of Public Health were loudly criticized and largely rejected by Hong Kong citizens. A second proposal surfaced in December 2000 when the Health and Welfare Bureau released the consultation document Lifelong Investment in Health. While some of the Bureau’s proposals were viewed as acceptable, others evoked protests. The Hospital Authority (HA), which manages all of the public hospitals of Hong Kong, offered a third proposal when it responded to the Bureau with its Annual Plan for 2001-02. Doctors, professors, and ordinary citizens all seem to have their own opinions of what should, could, or definitely will not work. As the debates continue, it becomes clear that there is no easy fix. It also becomes clear when investigating the various attributes and problems of the current system, however, that something needs to be done if Hong Kong is to continue providing up-to-date, effective health care for its citizens.

Mariam Ahmad