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Insurance companies reject Chinese medical claims

The Young Reporter (2004, May), 36(08), pp. 1.
Author: Fred Lai Cheuk-yin. Editor: Sherman Lam Cheuk-man.
Permanent URL - https://sys01.lib.hkbu.edu.hk/bujspa/purl.php?&did=bujspa0015390

By Fred Lai Cheuk-yin

03010015@hkbu.edu.hk

WITH community support and professionalism, Chinese medicine practitioners (CMP) are hoping to win the trust of both employers and insurance companies.

Dr Li Min, Assistant Professor of School of Chinese Medicine at Hong Kong Baptist University, says that there is sufficient public confidence for the government to place equal emphasis on both Chinese medicine and Western medicine.

“The School [of Chinese Medicine] has four clinics and most of the practitioners have to work overtime. Many patients have sought consultation in public hospital but showed little improvement in their conditions, so they turns to Chinese medicine,” Li says.

Ranic Leung Chun-chuen, President of Hong Kong Chinese Medicine Development Society, says the public has gained confidence in Chinese medicine after the SARS incident. But he says that some insurance companies still refuse to honour medical claims from patients using Chinese medicine.

“Some companies allow employees to claim a certain amount of reimbursement for Chinese medicine treatments. But it very much depends on whether Chinese medical services are covered by the medical insurance plan. Some insurance companies exclude Chinese medicine as a covered item,” says Leung.

For confirmation of sick leaves, the Chinese Medicine Practitioners Board of the Chinese Medicine Council of Hong Kong have consulted over 40 local Chinese medicine associations and formulated a reference guide on issuance of medical certificates by registered CMPs in December 2003.

The reference guide provides guidelines to registered CMPs about how to issue medical certificates according to the sickness of the patients. For example, patients suffer from fever or stomachache would be given 1 to 2 days of sick leave. Patients of illnesses which are more serious, like apoplexy or cancer, would be given a sick leave as long as a week.

“We do follow what is stated in the employment ordinance, and since the medical certificates of the Chinese medical practitioners are not yet endorsed by the ordinance, we would not accept these certificates as supporting documents for employees to apply for sick leave,” a spokesman of PARKnSHOP says.

The Chinese Medicine Practitioners Board states that the Quide does not have any statutory status, but it is used as reference for registered CMPs only. The registered CMPs should issue medical certificates based on professional judgment and patients’ individual circumstances.

Dr Lin Zhixiu, Assistant Professor of School of Chinese Medicine, the Chinese University of Hong Kong, believes the registered CMPs would exercise their discretion in issuing sick leaves.

“Chinese medicine practitioners are also professionals. They must meet strict requirements stipulated to be registered practitioners,” Lin says.

According to the Hong Kong Medical Association, the relevance of the symptom, possible causes and prognosis, the subjective feeling of the patient, the apparent effect of the sickness on the patient, and the nature of the job of the particular patient are all important factors to be considered.

Mrs Chan Liu Yuk-sau, a restaurant cashier, says she will put western medical services as her first priority when she gets sick.

“When I am sick, I would visit doctors of private clinics before turning to the Chinese medical practitioner. I can get a medical certificate which is recognized by my boss there,” says Chan.

Ms. Yeung Ping, manager of the Cung Ching Home for the Aged, shares similar opinion.

“Chinese medicine is not convincing enough. I would suggest my employees to go to government clinics or hospitals for consultations,” says Yeung.

There are also ongoing requests for an English version of the Chinese medical certificates. But according to the Chinese Medicine Council, the certificates are written in Chinese only. Dr Li Min has participated in the preparation of the reference guide. She admits that there are still difficulties in preparing an English version of the certificates.

“It is difficult to give Chinese medical terms an exact English wording as there is still no consensus for translation between the practitioners,” Li says.

Despite the difficulties, Dr Li saw Hong Kong has its capability in promoting the translation process of Chinese medicine. She suggests the local universities make their contributions in translating Chinese medicine terms into English in order to reach out to foreign medical professionals.

Edited by Sherman Lam Cheuk-man

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