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Table 3.2
Past recommendations on health financing reform in Hong Kong

Title Health financing-related discussions
Improving Hong Observations:
Kong’s Health • The long-term financial sustainability of the current healthcare system is
Care System– highly questionable, given a continuous rate of growth in public
Why and For healthcare expenditure driven by an ageing population, increasing
Whom, 1999 specialisation in medicine, and rising public expectations for quality health
(The Harvard services.
Team, 1999)
Recommendations:
• Establish Long Term Care Saving Accounts (MEDISAGE),
contributing towards individual long-term care insurance policy
• Launch Health Security Plan, covering inpatient hospital services and
specialist outpatient services for certain chronic diseases; to be jointly
paid by employers and employees
• Implement Competitive Integrated Health Care, in which the
Hospital Authority (HA) is to be reorganised into 12 to 18 regional Health
Integrated Systems (HISs) that can contract with private GPs and
specialists (or physician groups) to provide a defined benefit
package that will include preventive, primary, outpatient, and hospital care
Lifelong Observations:
investment in • At present, public healthcare services are heavily subsidised by general
Health– revenue. As health care cost continues to grow against a background of
Consultation an ageing population, advances in medical technology, and rising
Document on community aspirations, the need for major increases in the allocation of
Health Care public revenue to healthcare shall be investigated.
Reform, 2001
(HWB, 2001) • Our future public healthcare system shall continue to be supported
primarily by allocation from general revenue. To ensure long-term
sustainability, we propose targeting public subsidies towards
areas of greatest needs, supplemented by affordable
contributions and medical savings plans by individuals in their
working lives.
Recommendations:
• Improve the public/private interface through overcoming
professional barriers by adopting common clinical protocols and sharing
staff training and development programmes, developing computer-based
Health Information Infrastructure, and developing new healthcare
insurance policies with the medical insurance industry
• Improve cost efficiency, by reducing costs and revamping public
fees structure
• Establish Health Protection Accounts, to be funded by mandatory
contributions from the working population

A Study on Health Observations:
Care Financing • To address the financial sustainability of the Hong Kong
and Feasibility of healthcare system, there is a need to continue with the short-and
a Medical Savings medium-term measures including the introduction of rigorous cost-
Scheme in Hong containment measures in the public health care system, and continual
Kong, 2004 review of the public healthcare fee structure to ensure that resources can
(HWB, 2004) be targeted at patients and services of the greatest needs.
• Further studies will be needed to develop new financing options that will
be sustainable in the long-term, and equitable and accessible to all
members of the community. These options should address not only the
appropriate mix of financing sources for Hong Kong, but also other issues
like target subsidy, cost control measures, and interface between
public and private sectors.
Recommendations:
• Introduce a medical savings scheme: however, it is important to examine
carefully the role of a medical savings scheme. it is beneficial to conduct
further discussion with the private insurance industry to
explore the provision of new insurance products that could enhance the
scheme’s flexibility and attractiveness.

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