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The Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, has reassured members of the public that the lower-income group, elderly and chronic patients will be adequately protected when medical fees are revamped.
The Government would uphold its long-held policy that no one would be denied adequate medical care because of insufficient means, he stressed.
Announcing the levy of a new charge on Accident and Emergency (A&E) service approved by the Executive Council this (November 5) morning, Dr Yeoh said at a press conference that Comprehensive Social Security Assistance (CSSA) recipients would continue to be exempted from charges on medical services provided by the Hospital Authority (HA).
The new charge of $100 per attendance would be introduced for A&E service at public hospitals under the HA from November 29, 2002.
"We shall have a medical fee assistance scheme to protect vulnerable groups including not just CSSA recipients but the lower-income group, elderly and chronic patients.
"As the whole fee restructuring goes on, we will certainly assess the impact of those changes on different groups and the community, and strengthen the medical fee assistance scheme accordingly.
"We shall develop a set of objective criteria for use by the HA to assess the eligibility of patients to apply for partial or full exemption from public medical fees.
"Factors such as the patient's financial condition in relation to the Monthly Median Domestic Household Income, clinical condition in terms of frequency of use of the services, and age would be considered in determining the eligibility for full or partial exemption.
"By introducing A&E charge, we hope to encourage patients to consider alternative mode of medical service that best suits their needs, and free up valuable resources at A&E departments to attend to genuine emergency cases," Dr Yeoh said.
In 2001/02, there were about 2.5 million A&E attendances, of which some 75 per cent were classified as semi-urgent or non-urgent cases. Utilisation of A&E service in Hong Kong is 333 out of 1,000 population, as compared to 150 in the United States and 230 in Taiwan.
"International experiences support that imposing a user charge for A&E service is an effective means to reduce inappropriate use and misuse of the service.
"International studies also reveal that most developed economies have imposed a user charge for A&E service and Hong Kong is a very rare exception to this practice," he said.
Dr Yeoh also announced that fees and charges for other health care services at public hospitals and Department of Health clinics would be increased when the Financial Secretary lifted the current moratorium on public fees (please refer to details in Annex).
He stressed that the proposed rate of increase was modest and should be generally affordable.
"While the fee increase for general in-patient service will be modest, the charges for convalescent, rehabilitation, infirmary and psychiatric beds in general hospitals would remain unchanged in view of the relatively long stay of these patients.
"CSSA recipients will continue to be exempted from payment of all fees in the public health care sector," he said.
He pointed out that the present fee structure had not been revised since 1996. At present, the rate of Government subsidy in public medical expenditure is close to 97 per cent. Even after the fee restructuring, the total subsidy is still around 96 per cent.
"The fee increase is necessary to maintain the level and quality of public medical and health services provided to the community under the concept of shared responsibility between the Government and the community," Dr Yeoh said.
"Due to our ageing population, rapid technological advances and increasing community aspiration, our public health care system is suffering from an intensive financial pressure as the cost to maintain it has been increasing swiftly and there is concern on whether the system's long-term financial sustainability can be maintained.
"A full-scale review of the existing fee structure has been suggested in the Consultation Document on Health Care Reform published in December 2000 as one of the three strategic initiatives in ensuring the long-term financial sustainability of the health care system.
"A team of health care economists from the University of California, Berkeley, was commissioned to assess the impact of fee restructuring on the utilisation of public and private health care services.
"Findings of the study were used as a basis for determining the most appropriate level of fees in this fee review exercise.
"Meanwhile, as part of the fee restructuring we are reviewing the policy on private purchased medical items charged in the public medical system," he said.
End/Tuesday, November 5, 2002
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Annex : Restructuring of Fees and Charges for Public Health Care Services
