Leung Sui Lun
The Hong Kong Polytechnic University
This total 18 pages assignment is prepared for Sociology of Health (APSS281), taught by Mr. Kenneth LO
According to report by United Nations (2006), Hong Kong’s life expectancy ranked second among the world, while public health care expenditure only occupied 2.9% of GDP in 2006 (Hong Kong Year Book, 2006). It could be seen that Hong Kong public healthcare sector are both effective and efficient. However, the system had been challenging by various problems (see Table 1). Limited resources provided by public sector could not satisfy the increasing demand. Healthcare service was excessively abused. Patients in genuine need could not get their service as soon as possible. Minor illness deteriorated to be serious one. There was no end for government to invest more resource in healthcare system. Therefore government had proposed several healthcare reforms to solve problems since 2000. In which market funding method had been preferred to reduce government’s financial burden. Hong Kong government always emphasizes “Big Market and Small Government”. Does this principle still work in healthcare field? This article first discusses existing problems, and then provides an analytic argument on two financing models and healthcare reforms.
Public hospital and clinic in Hong Kong are always overloaded. It can be attributed to population ageing. After World War II, lots of babies were born between 1946 to1964. This phenomenon was called Baby Boom (Bostrom, 2005). This group of people starts to age now. Their demand for healthcare service is reaching the peak for next several decades. In addition, the charge for specialist healthcare and major surgery in public hospital is cheaper but quality is not much different (see Table 2). Public sector copes with most of tertiary care case. It even increases staff’s workload and affect service supply. In general many compliant of long waiting time for public healthcare service. Some patients had waited for three days in emergency department in public hospital (劉江華, 2002). Also, service abuses are common, for example, some people without any illness visit doctor just for a sick leave certificate. Long waiting time delay the treatment of disease, cure rate is affected as a consequence. When disease deteriorates, more resources have to be involved.
Next, expenditure on healthcare system is continually increasing. It is anticipated that public healthcare expenditure would climb to 5.5% of GDP in 2033 (Hong Kong Government, 2008). Population ageing, which requires hospital to allocate more resource involved to satisfy need, is main reason for the rise in expenditure. Besides, technological improvement increases medical cost (Chaudhry, Wang, Wu, Maglione, Mojica, Roth et al., 2006) For example, some linear accelerator can be effective in killing caner tumor with limited side effect, but whether their cost or maintenance fees are considerable. Also, introduction of new drug in “hospital authority drug formulary” imply higher cost.
Public Funding System
Public sector constitutes main body of healthcare system, whereas private sector is subsidiary. In fact, our total healthcare system still has capacity to cope with all patients. Our problem is that patients prefer service provided by public sector rather than private one. Private clinic and hospital generally is more expensive in charging, though their quality of service is better. Why public sector is still more preferred by most of people? It can be explained by healthcare funding system. Hong Kong, ever been colony of Great Britain, adopts a policy that healthcare is access to all irrespective of race, gender, age, disability, religion or relief (Department of Health, 2012). Government is of...