¡§I must congratulate Dr. Chow for making such a good proposal for Healthcare Reform. It looks as if the Medical Rose Garden painted by the Bureau would have the finishing touch by the people of Hong Kong. My worries came when I realized in the Consultation Document that when most of the medical revenue goes to the hands of the Government, a huge Government HMO like organization would be created and there would be endless hardship to those colleagues working in the private sector.¡¨ I gave this first response to the meeting after briefing by Dr. Chow Yat Ngok, the Secretary for Food and Health, in the early morning of 13 March, 2008 in Murray Building before the official release of the Consultation Document in the Legislative Council later that morning.
My worries were perpetuated by the inertness of the response of the Hospital Authority to our demand on proposed fee revision in the Tin Shui Wai North Public Private Participation Project (TSWNPPPP) and also by the lassie faire attitude of the Government in the regulation of HMOs in Hong Kong recently.
As discussed in my last message, even after thorough discussions with the Hospital Authority on the TSWN PPPP through meetings, phone conversations and even seminar in the Princess Margaret Hospital Sunday Afternoon Symposium on 24 February 2008, yet our demands for the proposed consultation fee revision were not addressed. There is further hint that the consultation fee of HK$ 150.00 would remain unchanged.
For the same reason, even though we have bombarded bluntly on the unethical behaviour of HMOs, including high administrative fee up to 50 to 60%, for the past years in the public and even twice in the meetings of Health Panel of the Legislative Council, the Government seems to turn a deaf ear to our outraged cry for stringent regulations. One of the reasons they uttered is there will be lots of people losing jobs in this HMO industry if the control is too tight. That is the main reason why the Authority just propose a voluntary registration scheme to so call regulate the HMOs but in fact try to regulate us, private medical practitioners.
What would we expect from the proposed family doctor register and PPP projects when the Government would not listen to us? What would we expect offers of insurance schemes from Mandatory Private Health Insurance (Supplementary Financing Option 5) or Personal Healthcare Reserve (Supplementary Financing Option 6) of the Consultation Document when the behaviour of HMOs remain status quote? Rather, with the help of HMOs in the market, we would expect more stringent control by the Government on our private colleagues. This will be the beginning of the era of the Government HMO.
Only when the Government is sincere in talking with us can we cooperate in the proposed mechanisms for PPP! Only when the Government is determined in allowing only members of the medical profession can operate medical business, as in lawyers, accountants, engineers etc provided by their respective professional legislations, would the behaviour of HMOs not getting uncontrolled!
We have been fighting for Legislation of Incorporated Medical Practice for years and we have tried to form the ¡§All Hong Kong Doctors Group¡¨ before. Without the realization of such endeavors, should we give the green light to the Government proposed Healthcare Reform?
On further study of the Government¡¦s proposals, only the Strengthening of Public Healthcare Safety Net is acceptable. The privacy problems should be dealt with and solved before we can agree on the implementation of the universal Electronic Health Record Sharing.
The HK$50 billion allotted from the fiscal reserves of the Government should assist those who wish to subscribe to private medical insurance with Authority approved scheme. Further incentives like tax exemption should be implemented to encourage citizens to look after their health through subscriptions to the Voluntary but not Mandatory Private Health Insurance.
Like Mandatory CME, we should object to measures made mandatory. We should support measures to achieve the principle of ¡§Small Government and Big Market¡¨. With this principle, we should not consider Mandatory Private Health Insurance or Personal Healthcare Reserve.
Like most changes, we believe in step-by-step implementation. So other proposals in Supplementary Financing Options like Social Health Insurance with appropriate tax increase on commodities, and Out-of-Pocket Payments with increase fees in Hospital Authority or public health services can be considered and be implemented gradually.
We have designed a survey on the proposed Healthcare Reform Consultation Document which can be downloaded from www.beStrong.gov.hk. Please do help us to return the filled in surveys so that your views and opinions can be collectively reflected to the Government before the deadline of 13th June 2008.
Many thanks!
Dr. Yeung Chiu Fat Henry