Policy of Hong Kong in Healthcare System - Essay Example

?Running head: POLICY ANALYSIS & CRITIQUE Policy Analysis and Critique In the era of globalization and advanced technical knowhow countries are making significant reforms in their various sectors. In such a respect Hong Kong is also not left behind. The country has made a number of alterations within the healthcare sector. The reforms have been directed towards providing better health care services to the country’s citizens. The Department of Health is entrusted with framing policies for country’s healthcare care services and also to facilitate efficient allocation of resources (Overview of the Health care system in Hong Kong, n.d). It has implemented new policies and modified existing policies. Several modifications have been made in healthcare practices and management. New pricing policy has been introduced in Hong Kong healthcare sector. The country in 2002 has introduced charges for patients who are admitted in hospitals under emergency situation or after meeting with an accident (Bowling, 2007). The reforms have lead to noticeable reduction in death rates and increased life expectancies. Better treatment is available from efficient health care professionals at a considerably low cost (Development and Financing of Hong Kong’s Future Health Care, 2007). Keeping this at the backdrop the current paper tends to present a critical review of the pricing policy that has been implemented for the health care system of Hong Kong. The public hospitals and clinics in Hong Kong receive a good amount of subsidies from the government so as to provide medical treatment to the citizens at the lowest possible cost. The government despite such high quality medical care has imposed low rates of taxes. However government is expected to bear the burden of expensive medical facilities which is likely to increase in the upcoming years. The estimates have shown a continuous increase in governmental expenditure for health care (Development and Financing of Hong Kong’s Future Health Care, 2007). Pricing Policy of Hong Kong Healthcare System Health care services in Hong Kong are considered to be a mixed one. The public sector has taken up the responsibility to give 92 percent of the hospital services. About 85 percent of primary care is provided by the private sector. Most people approach public hospitals for complex diseases in Hong Kong mainly due to the low cost of treatment (Fitzner, Coughlin, Timori and Bennett, 2000). The fees charged by public health care institutions in Hong Kong are very much less compared to other countries. Government has imposed strict regulations on these public sector fees. However patients have a hard time trying to get to the physician. The healthcare system is very time consuming. Patients have to pay a high cost in terms of inconvenience and time consuming treatment. Physicians often send their patients to emergency department in order to get a simple diagnostic test done. The emergency department remains filled with such patients depriving the actual needy ones from proper treatment (Hay, 1992, pp.35-36). However medical treatment for diseases like tuberculosis is performed free of cost. However to make such a low cost medical system sustainable for the country is a major challenge before the government (Hong Kong (China), 2010). It is becoming increasingly difficult for the government to meet the expenses of such low cost medical treatment. Recent economic predictions have shown increase in tax rates to finance healthcare needs. Such a pricing policy under health care system have made even the richer sections rush to public hospitals for treatment. The demand for such health care facilities has been continuously growing (Hay, 1992, p.51). Clearly Hong Kong has adopted a non- interventional for its public healthcare system. The pricing policy was aimed at providing medical facilities to those sections of population that cannot afford medical treatment elsewhere. Reforms have also been made in the structure of funds in Hong Kong to adopt such a pricing policy under healthcare. As per the employee benefits in Hong Kong, employees are given discounts for medical treatments as well as for physician consultation. The levels of benefits vary according to ranks and performances in offices. The medical insurances that are offered in Hong Kong have given cost benefits inpatient as well as outpatient medical services. Chinese medical treatments are also included under the health insurance coverage. In 1993 governments had made modifications in pricing policies during which medical fees underwent a change. During the same period government implemented pricing policies so as to review the funding arrangements (Courtney and Briggs, 2004, p.68). A number of missionary hospitals and clinics owned by Chinese practitioners exist in Hong Kong. They have delivered substantial care to the local citizens. Under the health care policies government has not specified any particular class or group who are eligible for such a free or concessional medical treatment. These facilities have been made available to all the citizens. A consulting firm was established by the government in 1983 to review the costs of health care services and suggestion of measures so as to make these services much better (Courtney and Briggs, 2004, p.63). A separate authority known as Hospital Authority (HA) has been set up to mange services and costs of public hospitals. The total number of out- patient clinics established under HA was found to be 13.85 million in 2010. The medical facilities of Hong Kong also include ambulance services to carry the emergency and accident injured persons to the Accident and Emergency (A&E) department. Treatment in public hospitals is comparatively low in Hong Kong. The fee for getting admitted to public hospitals is as low as $50. $100 is the charge for hospital beds with better facilities. The government has also left out hospital fees for those citizens who cannot afford to pay. For private hospital the fee ranges from $150 to $ 400. This is much more compared to the fee for public hospitals. Thus only 12 private hospitals exist in Hong Kong currently. The Hong Kong government has implemented health care policies for family planning. Under such policies the couples attending the program are paid $1 for every visit. To ensure well being and better health care facilities for school children, government has introduced the school children program. Under such a program physical examination are conducted for children either at concessional rates or free of cost. Government has also introduced pricing policy for Chinese medicines. The consultation fee for such Chinese practitioners has been fixed at $120 (Public Health, 2011). The medical infrastructure developed for healthcare has been the advanced type. The health care that are available in Hong Kong in recent times are comparable to the facilities offered at developed European nations. The emergency facilities in Hong Kong have been remarkable. Public hospitals offer good facilities for cases of child birth and also for surgical cases. However health care professionals in Hong Kong are known to have a tendency to overprescribe medicines to patients. For legal workers in Hong Kong the cost of private consultation is also included under health insurance policies (Castro, 2009). The SARS committee in 2003 had recommended 46 measures to instill the sense of responsibility within the public healthcare system and also prevent spreading of infectious diseases that easily gets transmitted to other individuals. To deliver these facilities in public hospitals at a considerably lower cost the Hong Kong government incurred an expenditure of HK$1 billion from its yearly budget. These measures specifically revolved around the Center for Health Protection (Gauld, 2005, p.196). Such a health care system in Hong Kong has received active support and contribution of the state government. Insurance and health benefits of the state have played a major role in the pricing policies implemented under the health care system in Hong Kong (Gauld, 2005, p.13). The new reforms for health care have mainly been directed towards arrangement of funds and management of public hospitals. The impact of traditional medicines and practices on the health care system in Hong Kong is noticeable (Gauld, 2005, p.14). Critical Review Merits of pricing policies for healthcare in Hong Kong The biggest achievement of healthcare system has been to offer high quality medical treatment to the entire population. The country has been able to maintain the notion of equal medical treatment facilities to all the citizens. No one has been deprived from the benefits of public health policies. Moreover a majority of the governmental health care facilities are offered free of cost. Out of pocket prices are not charged in any of the public hospitals. Medical treatment has been made so economical that it can be afforded by all (Hay, 1992, p.25). The population of Hong Kong enjoys better health standards compared to most of the other countries. Full credit for this goes to the health care facilities and particularly the pricing policies adopted under the health care system in Hong Kong. Moreover Hong Kong has also included measures that have helped in preventing diseases. The health care services include children health service, dental care service, elderly health service that has achieved the objectives of a healthier nation. Through such facilities Hong Kong has also been able to bring down the mortality rates owing to age and poverty (Public Health, 2011). Healthcare which is considered as a luxury good under the subject of economics have not remained so under the health care system of Hong Kong. The concept of universal access to medical treatment and healthcare facilities that has adopted by Hong Kong has received encouragement and appreciation from other countries too. If the healthcare system of Hong Kong is evaluated in terms of cost benefit approach then it is considered to be positive and these facilities to citizens are termed as justifiable (Ho, 2001). The low cost medical treatment and healthcare facilities that are available in Hong Kong is financed by the collection of tax revenue from its citizens. Generally it is the middle and rich classes who pays the major amount of taxes. Thus they need to qualify for the available medical facilities of the nation. In this situation inclusion of only the poor for medical treatment and facilities cannot be justified. All the responsible taxpaying citizens need to come under the coverage of benefits (Ho, 2001). The pricing policies implemented for health care system in Hong Kong has clearly followed a FFS system. Such a system under healthcare has prevented discrimination when offering medical and health care facilities to different citizens at affordable rates. The payment system involves a universal insurance package which has been considered beneficial for all citizens. Such a provider response to the payment system adopted by Hong Kong is now being recommended for well being of other Asian developing countries. The system has led citizens to perform expensive medical tests at comparatively cheaper rates. Without such facilities of low cost medical tests the poor as well as medical class would not have been able to detect chronic diseases and receive relevant treatment (Mahal, Debroy and Bhandari, 2010, p.120). The health care policies implemented in Hong Kong have differentiated between purchaser and provider to establish a system of efficient pricing. These has allowed in fixation of prices and quantities efficiently under the healthcare system. Through separation of funding arrangements from delivery of services it has been possible to enhance the quality of healthcare facilities. Other healthcare related objectives also have been possible to achieve by adopting such pricing policies under health care in Hong Kong (Gauld and Gould, 2002, p.174). Hong Kong has become one of the countries in the world to achieve the desirable and best figures with regards to vital statistics. There has been a significant dip in infant mortality rates. Also the life expectancies at birth have been continuously on the rising side. The low cost health care facilities providing medical treatment to all under the supervision of best health care professionals has been behind such a success of the nation. This in turn has led to a rise in the well being of the nation (Development and Financing of Hong Kong’s Future Health Care, 2007). De-merits of pricing policies for healthcare in Hong Kong The style and mode of medical treatment that is practiced at public hospitals at such an affordable rate have been highly criticized because of being too much time consuming. It is usually very difficult to get access to doctors in private hospitals owing to the long queue (Hay, 1992, p.25). Moreover the diagnostic tests take at least a month for completion which is totally unwanted in the field of medical treatment. This difficulty in getting access to private treatment and time consuming treatment are dragging patients towards private consultation. Reportedly in recent times about 65 percent of the patients have moved to private consultation (Hay, 1992, p.34). Under the Hog Kong healthcare system the medical facilities are delivered at affordable rates or free of cost. But at the same time government maintains a system of collecting low tax revenue from citizens. Such a phenomenon cannot be appreciated because it creates a pressure on the economy and shrinks down governmental revenue. Under such circumstances it is suggested that Hong Kong adopts the model of Switzerland for its healthcare system where healthcare spending by citizens are made voluntary. This could lead towards increasing efficiency of the Hong Kong healthcare system (Ho, 2001). The heavily subsidized healthcare facility needs to focus on a target group containing the poor. The poor should only be considered eligible for such healthcare facilities. In this case the current pricing policy adopted by government under healthcare system is imposing an excessive burn on the public hospitals and the entire healthcare sector. The same burden is tolerated by health insurance and other related health benefits (Ho, 2001). The long queue that is found for medical treatment in public hospitals under the low cost system deprives the needy ones from emergency treatment. They often have to go urgently to the private hospitals for medical treatment (Ho, 2001). Hence the low cost healthcare system of Hong Kong is not proper in the sense that many poor and needy citizens cannot accrue the benefits and are left unprotected. The Hospital Authority needs to pay considerable amount of attention to such a fact. The authority needs to implement policies and programs that ensure protection to the poor and the underprivileged ones so that they can get access to emergency medical treatment when needed (Response of the Hospital Authority to the Consultation Document on Health Care Reform- Lifelong Investment in Health, n.d). All the chargeable medical facilities have very low fees. In some cases they fail to cater to the needs of the patients owing to such low cost. Dissatisfaction often arises among the patient with available medical services. Hence it is very important that the health care system in Hong Kong changes the fee structure to be able to provide better medical services so as to fulfill the needs and demands of these patients coming to public clinics and hospitals (Response of the Hospital Authority to the Consultation Document on Health Care Reform- Lifelong Investment in Health, n.d). The sustainability of the pricing system that is found for health care system in Hong Kong has often raised questions. The high quality of medical care that is present for health care requires to arrange considerable amount of funds to enable the system provide the future generation the same quality of medical treatment. Currently the government is facing problems regarding the prices of health care facilities in the public sector. Moreover the costs involved in health care are expected to increase in future. It urgently needs improvement in the area of health care financing (Development and Financing of Hong Kong’s Future Health Care, 2007). The government needs to implement medical plans and policies for additional savings to sustain the low cost health care system in Hong Kong (Response of the Hospital Authority to the Consultation Document on Health Care Reform- Lifelong Investment in Health, n.d). Although Hong Kong has got excellent medical facilities for public hospitals at quite a low cost, the pricing policies adopted for public sector under the health care system in Hong Kong has not allowed the public medical institutions to integrate with the private hospitals. Thus public hospitals have lacked the amount of efficiency that is required for giving high quality medical treatment. Even the difficulty encountered during physician consultation in public hospitals and wastage of time for medical treatment and tests can be regarded as an outcome of the failure of such integration. It has also not allowed sufficient control over the entire health care system (Gauld, 2005, p.227). The long queue and overcrowded emergency wards that is witnessed in the public hospitals in Hong Kong has failed to control infectious and also failed in preventing spread of such diseases which easily gets transmitted from one to another individual. The overcrowding was simply a result of low cost medical facilities under health care system. Such pricing policies under health care have been held responsible for more spreading of infectious diseases such as SARS in Hong Kong (Gauld, 2005, p.196). Such a pricing policy maintaining low cost in the system of health care in Hong Kong has witnessed over intervention of the social workers. Without adequate knowledge and experience with policy making the social workers and their entire community have interfered in health care issues and policies including those which are related to pricing and cost management. Such interventions certainly have never been desirable (Rhind and Chan, 1997, p.xv). Conclusion With the emergence of the phenomenon called globalization Hong Kong like other countries have made sectoral reforms of which healthcare reforms deserves mention. It has enabled high quality health care facilities to all the citizens at remarkably low rates. Expensive and relevant medical tests are available at affordable rates. The health care system has provided medical treatment to all and thus prevented premature deaths resulting from ageing or poverty. The significant difference in rates between private and public hospitals has enabled the deprived ones to get relevant treatment. However such a policy of equality in medical treatment has resulted in long queues and overcrowding in the emergency wards in public hospitals. The hospital authority has failed to gain in effective control and these also lead to spreading of infectious diseases. Moreover the sustainability of such a low cost health care system has also raised questions because the government is still maintaining a low cost tax revenue system. To reduce such an excessive burden on the government and to sustain such a health care system the paper suggests to take up additional savings plan for providing medical facilities and to focus more on giving medical facilities to the deprived and needy ones who have not received adequate protection even with the prevalence of such a low cost health care system in Hong Kong. References Bowling, A. (2007). Hong Kong’s health system: reflections, perspectives and visions, Journal of Epidemiology and Community Health, 61(10) Castro, JM. (2009). Health Care in Hong Kong, ExpatForum, Retrieved on January 3 2012 from: http://www.expatforum.com/articles/health/health-care-in-hong-kong.html Courtney, M and Briggs, D. (2004). Health Care: Financial Management, Marrickville: Elsevier Australia Development and Financing of Hong Kong’s Future Health Care. (2007). Health Care Study Group of the Bauhinia Foundation Research Center. Retrieved on January 3 2012 from: http://www.legco.gov.hk/yr06-07/english/panels/hs/papers/hs0717cb2-2460-1-e.pdf Fitzner, KA, Coughlin, S, Timori, C and Bennett, CL. (2000). Health care in Hong Kong and mainland China: one country, two systems?, Health Policy, 53 , pp.147-155 Gauld, R and Gould, D. (2002). The Hong Kong Health Sector: development and change, Hong Kong: University of Otago Press Gauld, R. (2005). Comparative health policy in the Asia-Pacific, New York: Open University Press Hay, JW. (1992). Health care in Hong Kong: an economic policy assessment, Hong Kong: The Chinese University Press Ho, LS. (2001). Health care funding and delivery in Hong Kong: what should be done? , HKMJ, 7(2), pp. 155-161 Hong Kong (China), 2010, World Health Organization: Western Pacific Region. Retrieved on January 3 2012 from: http://www.wpro.who.int/countries/hok/2010/national_health_priorities.htm Mahal, A, Debroy, B and Bhandari, L. (2010). 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