60% of respondents choose public hospitals for the price

Does price really matter most to a patient?

60% of respondents choose public hospitals for the price

Does price really matter most to a patient?

Hong Kong people are living the longest lives.¹ Ironically, we are also living the most unhealthy lives.² Swamped with population ageing and diseases of affluence, Hong Kong is fronted with an exploding medical demand. In fact, according to theHospital Authority KPI Report³, the public specialist clinics recorded approximately 6,000,000 total outpatient attendances in 2018 (150,000 more than 2017’s). Generally, citizens choose the public sector over the private counterpart even they are well aware of the former’s patient overload. According to the survey data⁴, public hospital service are preferred because of lower cost (60%). That said, they may have overlooked the “hidden cost” of choosing public hospitals, which could be way more burdensome and grievous than the medical expenditure.

The hidden plight of public hospitals

It is of no doubt that the public healthcare services are more budget-friendly. However, the affordable pricing has caused the public sector numerous drawbacks. According to one of the press releases by the Government of the HKSAR⁵, it revealed that during the recent influenza surge, the number of medical inpatients exceededthe number of medical inpatient beds by a staggering 20% in some public hospitals! When wards are fully occupied, some patients even have to sleep in the corridors.⁶

Moreover, the public healthcare system is infamous for its prolonged waiting time. The following hypothetical case study⁷ will exemplify it perfectly. Mr. Chan notices a change in his bowel habits and decides to see a doctor at a public specialist clinic. If it is classified as a stable new case, the Hospital Authority’s data⁸ show that he may need to wait for more than two years (i.e.111 weeks) to get the treatment. After the two-year long wait, he can finally see a specialist doctor but is unfortunately diagnosed with colon cancer. In order to receive a cancer treatment, he needs to be referred by the clinic doctor before he canschedule a surgery. However, data show⁹ that he has to endure another eight weeks of waiting before he receives his first cancer treatment. In other words, after the symptoms first appear, Mr. Chan has to wait for a total of 2.5 years before he receives an effective treatment.

Sadly, a year later his cancer returns. Undergoing a targeted therapy, whose drugs are listed as self-financed items in the Hospital Authority’s Drug Formulary, Mr. Chan has to pay HKD20,000 - HKD30,00010 per month in order to win the second battle against cancer. Since he has lost the ability to work, the treatment imposes an unbearable financial burden on his weakened shoulders.

VHIS opens the gateway to private healthcare services

The government launchedthe Voluntary Health Insurance Scheme (“VHIS”) on 1 April 2019. In general, its “Standard Plan” enables insured person to obtain a HKD420,000 coverage per policy year — covering expenses like pre- and post-confinement/day case procedure outpatient care, surgeon’s fee, anaesthetist’s fee, operating theatre charges, and room and board. Using the same example, if Mr. Chan is an insured person of a VHIS Standard Plan, he can visit a private hospital right after symptoms show. If the doctor diagnoses him with colon cancer and advises him to receive acolectomy, he can promptly do so at any private hospitals. Let’s say he has the surgery and stays at the hospital for nine days. It costs him HKD192,710 in total11, and he claims the expenses via a VHIS policy. The compensation breakdown would be as follows12:

Benefit items

Benefit amount (in HKD)

Surgeon's fee

(Major operation)

Surgeon's fee

(Major operation)

25,000

Room and board

Room and board

6,750

Attending doctor's visit fee

Attending doctor's visit fee

6,750

Anaesthetist's fee

(35% of surgeon's fee payable)

Anaesthetist's fee

(35% of surgeon's fee payable)

24,248

Operating theatre charges

(35% of surgeon's fee payable)

Operating theatre charges

(35% of surgeon's fee payable)

24,248

Miscellaneous charges

(Maximum)

Miscellaneous charges

(Maximum)

14,000

Total

Total

100,996

As the table shows, Mr. Chan can in fact claim more than half of the total cost. With VHIS, he can now pay less to enjoy the abundant resources provided by the private hospital, so that he can comfortably and quickly restore his health. Even if he takes targeted cancer drugs during the relapse, he can make use of the HKD80,000 benefit limit in “pre-scribed non-surgical cancer treatments” to alleviate his financial burden.13 What’s even better is that VHIS’s benefit limit resets every year, meaning that if Mr. Chan uses up all HKD420,000 coverage for this year, he will have another HKD420,000 coverage in the next policy year until the age of 100. It is no wonder that over 80% of people consider participating in VHIS.14

Undeniably, VHIS helps lift some of the financial burden off a private hospital patient’s shoulders. Indeed a surgery might cost you your savings, but a critical condition will cost you your life. To a suffering patient, being able to skip the wait and receive a timely treatment is the biggest, most-needed blessing they can get. Therefore, VHIS will attract especially middle-class families and the higher-income group to switch to the private sector. This would in turn help balance private and public service provision, and ultimately allow more patients to treated sooner.

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