Prioritize healthcare resources for Hong Kong residents

Hnong Kong’s public healthcare system operates on a “treat first, pay later” principle, offering equal treatment to all. Given that over 90% of the system is government-funded, I believe the principle should prioritize serving Hong Kong residents first. Non-residents - including illegal entrants, overstayers, and foreign tourists - are classified as “non-eligible persons.” Although the Hospital Authority (HA) requires “non-eligible persons,” or those unable to prove eligibility, to pay a deposit upon admission to public hospitals, many leave without settling their medical bills after using public healthcare services. This has also led to cases where individuals deliberately come to Hong Kong seeking treatment for serious illnesses.

Since non-residents are not eligible persons, I propose encouraging them to purchase insurance before entering Hong Kong. A few days of travel insurance is very affordable. This measure would not only ease the burden on Hong Kong’s public healthcare system and public finances, but also benefit the patients themselves. Looking ahead, Hong Kong should review the definition of “eligible persons” for public healthcare services - for example, whether restrictions should be imposed on individuals who have emigrated overseas and return for medical treatment.

Promote public healthcare fee reform

For eligible persons, and in line with the principle of optimizing resources, priority should be given to younger and elderly Hong Kong residents. For those aged 21 to 60, the authorities could implement policies that encourage the purchase of medical insurance, thereby increasing their co-payment share for public healthcare services. In the past, low co-payment ratios have led to excessive demand, resulting in resource misallocation. Therefore, I strongly support the public healthcare fee reform announced by the authorities in March this year. This reform - guided by the principle that no one should be denied appropriate medical care due to financial constraints - aims to strengthen medical protection while reducing waste and abuse through a restructured public healthcare subsidy system.

In the future, the HA could consider introducing “fixed-price medical packages” at transparent prices lower than those charged in the private healthcare market. These packages would allow highly skilled and experienced HA doctors to provide treatment within the HA system to patients who opt for such packages, while also earning additional income for delivering these services. This approach would not only expand citizens’ choices within the healthcare system but also help reduce the premature outflow of HA doctors to the private sector.
 

Promote widespread aging-in-place

Hong Kong is undeniably entering an aging society and must strive to make aging-in-place a viable lifestyle. The government has adopted aging-in-place as a more policy direction, introducing community care services and the Community Care Service Voucher Scheme for the Elderly. However, the current supply of these services cannot meet the demand of those on waiting lists. Moreover, these services rely heavily on public funding. In the long term, I suggest the government actively explore directions for long-term care financing options. For government-led insurance systems, Hong Kong could learn from Japan’s well-established model, which features a tiered eligibility framework for services with standardized fees, subject to regular review. Since 2016, Mainland China has also implemented a long-term care insurance system, with Guangzhou’s pilot program adopting a public-private partnership model that has proven effective and well-organized. Guangdong Province is also accelerating the development of a commercial long-term care insurance market, promoting personalized long-term care insurance products. These policy measures have effectively stimulated the growth of the care market and offer valuable insights for Hong Kong’s development.