What Are The Major Challenges Of Current Health Care System In Hong Kong
What are the major challenges of current health care system in Hong Kong? How should we reform the system? What should be the roles of individuals, market and government in funding and managing the health care system?
Major challenges
Increased health care financing costs due to increased demand of health care service
The ageing population
The bulk of inpatient care is subject to a spending cap
~ 90 % of the most expensive services - secondary and tertiary care-are delivered by the public hospital system.
This public hospital system is subjected to a strict spending cap.
The Government appropriates a fixed sum every year to finance public hospitals.
The grant is virtually the only significant source of income for these hospitals.
The fees and charges received from patients constitute less than two per cent of actual total cost, and the public hospitals are not allowed to raise fees without the consent of the government.
Expenditure caps have proven to be effective in containing costs in other countries as well (Butler, 1989; Brudevold, 1994; Jonsson, 1990).
Public hospital staff on fixed salary
Over 80 % of the recurrent expenditure of public hospitals goes to personnel (Hospital Authority, 1998, p.76). All employees of these hospitals, including doctors, are compensated on a fixed salary basis. These fixed salary employees deliver the bulk of the territory's most expensive health care. Annual salary adjustments are made in line with those in the civil service-which are normally below general inflation -and are subjected to rather rigorous public scrutiny. 90 % of hospital care is delivered by public hospitals, and over 80%of expenditure of the public hospitals are salary expenses. By keeping salary expenses, the major cost-driver, under control one has, by and large, controlled the Territory's overall health care expenditure. Furthermore, there are no serious supply-side moral hazards associated with such remuneration system, as there are no
Major challenges
Increased health care financing costs due to increased demand of health care service
The ageing population
The bulk of inpatient care is subject to a spending cap
~ 90 % of the most expensive services - secondary and tertiary care-are delivered by the public hospital system.
This public hospital system is subjected to a strict spending cap.
The Government appropriates a fixed sum every year to finance public hospitals.
The grant is virtually the only significant source of income for these hospitals.
The fees and charges received from patients constitute less than two per cent of actual total cost, and the public hospitals are not allowed to raise fees without the consent of the government.
Expenditure caps have proven to be effective in containing costs in other countries as well (Butler, 1989; Brudevold, 1994; Jonsson, 1990).
Public hospital staff on fixed salary
Over 80 % of the recurrent expenditure of public hospitals goes to personnel (Hospital Authority, 1998, p.76). All employees of these hospitals, including doctors, are compensated on a fixed salary basis. These fixed salary employees deliver the bulk of the territory's most expensive health care. Annual salary adjustments are made in line with those in the civil service-which are normally below general inflation -and are subjected to rather rigorous public scrutiny. 90 % of hospital care is delivered by public hospitals, and over 80%of expenditure of the public hospitals are salary expenses. By keeping salary expenses, the major cost-driver, under control one has, by and large, controlled the Territory's overall health care expenditure. Furthermore, there are no serious supply-side moral hazards associated with such remuneration system, as there are no