People's preference: Health & Medical Development Advisory Committee Working Group on Healthcare Financing Chairman Ronald Arculli and Dr York Chow brief reporters on public feedback to healthcare reform proposals.

The public generally agrees there is an imminent need to reform the healthcare system and to have a consensus on the reform proposals, according to the report of the first stage public consultation on healthcare reform.

Releasing the report's results today Secretary for Food & Health Dr York Chow said in view of the community's desire for the early implementation of reforms, the Government has been allocating resources to implement a series of improvements.

They include the formation of the working group on primary care, implementing pilot schemes to support the chronically ill, pursuing public-private partnership pilots under the "money-follows-patient" concept, developing electronic health record sharing between the public and private sectors, and strengthening the public healthcare safety net.

Finance debate

Dr Chow said most of the public feel healthcare financing should be addressed. Although views were diverse on how to reform the financing arrangement, they agreed in-depth discussions should continue.

Nearly two-thirds of respondents said the financing system should be reformed, but did not show any mainstream consensus on the six proposed supplementary financing proposals. They generally agreed with the provision of a healthcare safety net for the low-income group and the disadvantaged by taxpayers, but tend to favour a supplementary financing option catering for individual needs.

Some said proposals of a mandatory nature have certain advantages, but there is a general reservation over mandatory supplementary healthcare financing proposals.

Dr Chow said there are views for and against proposals with elements of saving or insurance, but higher income groups tend to support those with insurance and less for those with savings.

While the public generally values the equitable access to the same standard of public healthcare by the population as a whole, many people supported having more choice of private services tailored to their own preference in addition to the basic.

If proposals requiring individual contributions to healthcare are to be adopted, people expect both employers and employees share the contributions, but employers have reservations on this.

If there is sufficient protection provided by the safety net, a number of people consider a user fee increase is a simple and direct means of financing.

Further consultation

As healthcare financing has a far-reaching impact on long term medical development, and the community is willing to continue deliberations on the issue, the Government will further study feasible financing options and hold the second-stage consultation, Dr Chow said.

When examining possible proposals the Government will take into consideration the following broad principles as reflected in the first stage consultation:

* to preserve existing public healthcare as a safety net for all, while providing better and wider choice for people who are using or able to afford private services;

* to take forward financing reforms through a step-by-step approach having regard to the range of views received, and consider possible proposals by stages, with a view to reaching long-term solutions;

* to consider standardised and incentivised arrangements to facilitate access to better protection and choices in healthcare with necessary flexibility to cater for the needs of different age and income groups; and,

* to be in line with the money-follows-patient concept, while ensuring sufficient protection to users for price transparency and cost-effectiveness.

Fiscal resources

Dr Chow said the Government will continue to retain $50 billion in fiscal reserves pending a decision on supplementary financing and consider how the funding can be made use of to assist the implementation of supplementary financing.

The Government plans to launch the second-stage consultation in the first half of next year. It will by then provide a more concrete proposal and figures for public discussion.

For more details of the report click here.