Letters | Two ways to get Hong Kong people out of public hospital queues

Like other spending on “social welfare”, public health care expenditure in Hong Kong aims at only building a “safety net” for those whose needs cannot be met by the private market, due to financial or other barriers. For instance, the government builds public housing for those who cannot afford a home in the private market, but would never try to build homes for all families in Hong Kong.

Indeed, the current problem facing Hong Kong is that citizens basically think public health care is a population-wide service, instead of one that is meant for the less-privileged. Everyone, rich or poor, insured or uninsured, rushes to public services because it is almost guaranteed to be good, that too for such a low price.

But, unlike public housing, there is no way to bar financially capable people from seeking public services, due to ethical concerns. In fact, almost all previous attempts by the government, such as the public-private partnership for certain chronic conditions and medical vouchers for older people, have quite clearly failed in driving patients from public to private services on a sufficient scale to ease the pressure in the public sector.

Given the limited capacity of private services as well as the limited tax breaks offered as an incentive, I am doubtful whether the recently introduced voluntary health insurance scheme would prove to be any more effective.

Should the public health care service then expand to such a dominant scale that it may act as a population-wide service, especially for outpatient services, of which the public sector only has a 30 per cent share? This expansion would inevitably imply an increase in health care expenditure by the government. With the rapidly ageing population and a foreseeable decline in government revenue in the coming decades, this expansion may be neither financially feasible nor sustainable.