The cost of public health care

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Book Chapter

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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

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