Most Hong Kong people who have experienced the long wait at emergency wards of the city’s public hospitals would not be surprised to hear the news that the Hospital Authority, which manages 42 public hospitals and institutions, has decided to raise the fee for accident and emergency services from HK$100 (US$13) to HK$180. The stated intention is to drive away non-urgent patients so as to cut waiting times and prevent overuse.
While jamming of government-run hospitals shows that our public medical services are excellent and highly affordable, their overuse strains public resources and affects the quality of services by, for example, causing a loss of medical personnel to the private sector. According to government figures, public hospitals take care of 90 percent of patients but employ just 40 percent of doctors.
As a matter of fact, those patients who choose to go to public hospitals’ emergency wards for medical consultation are paying an extra, non-monetary price for the service — the long hours they have to spend waiting for it. Apparently they feel that the time spent is worthwhile given the big difference in charges between public and private services. The fee increase is to narrow the difference, hence making the wait less worthwhile.
Few people would disagree that emergency ward services have been abused. But how effective will the new fee level be in diverting patients to the private sector? The consultation fees of private general practitioners these days are usually between HK$300 and HK$500. Raising the public hospital charge to HK$180 may have some effect for a while but past experience has already told us the effect will not last long. Some patient groups have expressed concerns that the fee increase in the public sector may lead to one in the private sector.
The effect of simply raising the fee in driving away non-urgent patients would seem to be short-lived at best. There are other options the government could consider, such as increasing general clinic services so people falling sick during holidays or odd hours won’t have to go to emergency wards. This, of course, would require more manpower, which is another issue the government has to handle. Increasing the monetary amount of medical vouchers and building more health centers for the elderly, who are frequent visitors to the emergency wards, should also be considered.
A more thorough solution is the proposed Voluntary Health Insurance Scheme. This is designed to redress the imbalance of the public-private healthcare sectors. Its implementation and continuous improvement should be able to help reduce people’s over-reliance on public medical services.