The cost of public health care

Document Type

Book Chapter

Publication Date

1994

Abstract

Since the publication of the Scott Report (Scott, 1985), the question of fees for public hospitals has aroused a considerable amount of attention. The report hinted that one should not expect the government to use tax revenue to increase funding to public medical and health services. A number of official documents subsequently appeared to suggest that a change in the existing policy of charging a nominal fee is desirable (Provisional Hospital Authority, 1989; Wilson, 1989). Discussions in non-government circles range from favouring the charging of the full cost (with alternative financing) (Wong, 1991; Hay, 1992) to advocating no change at all from the existing policy of charging an amount roughly equivalent to the cost of meals provided in public hospitals (Lee, 1990; UDHK, 1990). There was, however, no systematic evaluation of these proposals in terms of their effects on access and quality of care, and their longer-term implications on the health care system as a result of changes in the public/private mix in health services financing.

This chapter argues that any deviations from the existing fee policy of charging a nominal sum without first having an effective cost-containment/quality assurance strategy in place will likely result in a situation whereby the additional resources injected into the system, derived from the higher fees, would not benefit the patients in any significant manner.

Source Publication

Management Innovation: The Changing Face of Business in Hong Kong and Guangzhou

First Page

148

Last Page

157

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