HONG KONG: Prior to resuming consultations on healthcare reform next year, the government has decided to abandon the proposal for mandatory financing and focus instead on voluntary participation.

Initial discussions on the long-awaited reform were completed last June. The second stage of consultation was scheduled to commence early this year. However, that got derailed by the A (H1N1) influenza pandemic.

Chief Executive Donald Tsang Yam-kuen revealed in his policy address yesterday that the administration is turning to a supplementary financing proposal based on voluntary participation, which will include insurance and savings.

The decision came after the first round of consultation found little support for mandatory medical insurance. Approximately 70 percent of the public declared a preference for a voluntary scheme.

In last year's budget Financial Secretary John Tsang set aside HK$50 billion to kick-start the reform.

The sum may be used to provide direct subsidies or tax incentives to encourage public participation, a government source said.

For instance, the insurance could cover minor or medium-sized operations, but major procedures and conditions such as liver transplants or cancer might not be fully covered.

"This option will enable a wider choice of private healthcare services for those who can afford it, especially those who have been covered by health insurance. It will also ease the burden on the public healthcare system and make it more sustainable," the chief executive said.

The government will be responsible for standardizing and regulating the program, including the items covered in the insurance, details of the renewable terms and the adjustment of premiums.

An estimated 2,700,000 people have already purchased medical insurance. Vice Chairman of Health and Medical Development Advisory Committee Ronald Arculli said he believed a voluntary scheme will receive a more enthusiastic welcome from the public.

Chan Kin-por, a lawmaker representing the insurance constituency, was pleased to learn that the consultation is to resume next year and said he believed the public would be more willing to join the scheme under incentives.

"But the administration must formulate the best measures for participants who have already purchased their own health insurance," Chan added.

Sam Yu, social work assistant professor of Hong Kong Baptist University, was more critical. He observed there are still many uncertainties in the healthcare reform.

"The government never presents a clear picture of the problems associated in the current healthcare system and the consequences if people opt not to purchase the insurance," he said.

Yu said he thought more people may join the scheme if they know they can enjoy better services by just paying a bit more.

Meanwhile, Chief Executive Tsang said the government will consider providing extra facilities in vacant spaces of public hospitals.

The administration will also monitor market demand in considering whether to allow private land to be re-zoned for medical use, subject to planning permission.

The government had earlier addressed four sites at Wong Chuk Hang, Tseung Kwan O, Tai Po and Lantau for private hospital development.

Tsang said appropriate land disposal arrangements to ensure the provision of private medical services will be formulated after the period for expressions of interest closes at the end of the year.

The sites proposed, however, appear unappealing to the private sector.

Kwong Kwok-hay, deputy medical superintendent of Hong Kong Sanatorium & Hospital, thought the proposed sites are inappropriate for medical use.

"Wong Chuk Hang would be the most desirable, but there will be the MTR, which may affect the operation of medical instruments," he said.

(HK Edition 10/15/2009 page1)