Their proposals have been rejected by arioso stakeholders, who represented different, and even conflicting, values and interests. This paper describes the development of health services and the debates that have surrounded health financing since the late sass. It shows that the health finance debate In Hong Kong Is not a simple Issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly embroiled society.
Keywords: Health Finance, Health Policy, Health Services, Hong Kong, Public Health Services INTRODUCTION The earliest public health services in Hong Kong were mainly devoted to combating communicable diseases. As the government was largely unresponsive to demands for further services, the gap In provision was filled by traditional Chinese medical practitioners and hospitals operated by local philanthropic organizations. It was not until the late sass that the government expanded its role and investment in health care.
During the past five decades, a system of service provision has developed with a clear division of labor: the private sector oversees primary health care, and the public sector is responsible for the more expensive secondary and tertiary health care services. In terms of DOC 10. 4018/sphere. 2011040102 enhancing, the private sector is mainly funded From the sass onwards, there has been a heavier reliance on public health services in Hong Kong, due to improvements in these services and to the increasing number of people without the funds for private care.
The burden of financing these services will soon become even heavier due to the aging population. Facing these challenges, the government has repeatedly called for health finance reforms. However, all its proposals, with the exception of a medical fee increase, have been met with strong resistance, and no decisions have been reached. In the process, conflicts have arisen mongo various stakeholders and social classes, though all agree that some types of reform is necessary.
This paper describes the development and characteristics of public health services in Hong Kong since the sass, various proposals for Copyright 2011, GIG Global. Copying or distributing in print or electronic forms without written permission of GIG Global is prohibited. 18 International Journal of Public and Private Healthcare Management and Economics, 1(2), 17-25, April-June 2011 health care reform, and key conflicts among stakeholders. It will be shown that efforts for reform have been impeded by the welfare ileitis of this increasingly embroiled society.
For example, in 1980, the charge for out-patient treatment was HIKE$ 3 and for inpatient treatment, HIKE$ 5 per day. In the sass, public health services continued to expand: there was a 17. 5% increase in the number of government hospital beds during the decade. In the mid-sass, however, cost efficiency became a priority. The government stated that, The lesson of public health services all over the world is that increased expenditure does not necessarily translate into higher standards.
What is really important is the way the money is used and how well the facilities are managed (Hong Kong Government, 1989, p. 14). “The Delivery of Medical Services in Hospitals”, also known as the Scott Report was published in 1985 (W. D. Scott Pity Company, 985). It focused on health services administration, cost-recovery, and cost- containment. Improving the management of limited resources was a key issue in the sass. The Hospital Authority was formally established in December 1990, with the aim of maintaining the quality of services without increasing state investment.
While new forms of health financing were being explored, the easiest option-?to increase user fees-?was adopted. It was hoped that such policies could help to improve the Hospital Authority revenue and reduced demand on public health services (such as the accident and emergency services). In 1992, the out-patient e was raised to HIKE$ 21 and the in-patient ward fee to HIKE$ 43. These rates are now HIKE$ seems dramatic, it is consistent with the growth in the general income level (e. G. , the median household income was HIKE$ 9,964 in 1991, and HIKE$ 18,100 in the third quarter of 2010).
While the government concentrated in hospitals and clinics construction plan, the private sector continued to concentrate on primary health-care provision offered in small, individually owned clinics (in the past decade, there has been an increase in health-management organizations and group-practice clinics). The fees charged by these clinics are determined by he market and are not subject to government regulation. Most users pay for their treatment, though some are covered by health insurance that is either independently purchased or provided as part of an employee benefit package.
