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To Snatch or to Serve

The Young Reporter (2005, February), 37(05), pp. 11.
Author: Diamond Cheng Hei-suen. Editor: Rebekah Chan Yin-mui.
Permanent URL - https://sys01.lib.hkbu.edu.hk/bujspa/purl.php?&did=bujspa0007392

THIS year Chief Executive Tung Chee-hwa has stressed, in his policy address, the promotion of social harmony and stability through enhancing “people-based” governance. The highlight, to tackle poverty and reduce inter-generational poverty, is a great idea which however lacks comprehensiveness and practicality.

But just as we are starting to have a little more confidence to our government, a week after the Policy Address, the health minister announced his master plans to drastically increase inpatient and ER fees at public hospitals.

The proposition was a total shock. Accident and emergency unit (A&E) charges at public hospitals could increase by 50 per cent, from $100 at present to $150, which would be the second hike in three years. Besides, inpatient general bed fees would rise from $100 to $500 per day for short-term stays.

On top of that, specialist clinic charges may be raised. The government is also planning to either increase the medicine prescription fees or to reduce the maximum duration of supply from 16 to four weeks

Despite his promise last year that there would be no fee adjustment for A&E services, York Chow Yat-ngok, the Secretary of Health, Welfare and Food, attempted to justify such fee rises by saying that a jump to $150 could help discourage people with mino illnesses from abusing public clinic services.

“We want to instil a value in the mind of the public that the A&E service should be reserved for those in dire need, and also to increase the public’s reliance on private family doctors,” he said, claiming that people were finding that the $100 bill cheap.

Thanks but no thanks. Does he know which group of citizens rely most on public medical services? They are the grassroots, the elderly and the chronically ill. The rich do not have to spend more than two hours to line up at public clinics, as they could well afford to go to private doctors, who are generally considered to be more caring than their counterparts in the public sector.

The claim that “people are finding that the $100 bill is cheap” comes with no edvidence [i.e. evidence]. Did he actually go by himself to observe the lives of grassroots? How about the poor or the social security recipients who live in poverty-stricken areas in our city?

The sandwiched class-families with a monthly income of between $20,000 and $30,000, would suffer the most. They can-not afford the higher fees while they are not qualified for a government subsidy.

The local economy has just started to revive from the slump after SARS epidemic. Many still cannot enjoy real benefits from the economic growth, and a lot of social problems have yet to be solved.

The ageing of population has intensified, and more than a million people are in the low-income stratum, not to mention the vast income gap between the rich and the poor.

Dr Chow said the Hospital Authority has been suffering a huge budget deficit. In 2004-05 the deficit had jumped to over $500 million. Therefore, to raise public medical fees could help alleviate the deficit, and make people realise how costly medical care is.

To raise fees by 50% for the sake of deficit reduction and cost cutting is a short-sighted approach. Why is there such a huge deficit in the first place? Is it because of the welfare benefit pay-outs for the 170,000 strong civil service? Are medical resources being allocated effectively to help those who are really in need? Are more resources being delivered to withstand the mounting trend of ageing population? By simply shifting the financial burden to the public bu avoid hurting the interest of the civil servants, again reflects the irresponsibility of the government.

Although there would be a mechanism to take care of the poor, exemption from the fee hike is hard. An applicant’s monthly income could not exceed three-quarters of the median of the family income per month. Besides, the individual assets limit is also extremely stringent.

Take an example for a single 40-year-old applicant. To apply for an exemption his or her assets limit should not exceed $30,000. His or her family possess assets which are worth more than $120,000 in order to be qualified. Therefore if someone of a low income family feels chronically ill, they will not visit a public hospital until the very last moment, not because they don’t need treatment, but they dare not to, since they cannot afford to pay for the fees.

If such propositions are passed, the ultimate result will not be a reduction in medical deficit or a proper use of public medical services. Public health will be severely damaged because fewer people will visit the public hospital even though they are sick. Especially for the older and sandwiched stratum, who are hit by the policies and do not have extra money for an expensive medical charge.

Is this what we called “people-based governance” ?

What about the government also join in this “reducing medical deficit” campaign? If the public are to pay 50% higher medical fees, will it be fair if civil servants also cut a certain percentage of their salaries? As a Chinese saying does: Don’t snatch rice from a beggar’s bowl please.

Written by Diamond Cheng Hei-suen

Edited by Rebekah Chan Yin-mui

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