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A fixed-fee cure for private health care

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One of the problems with private health care in Hong Kong is that charges for treating the same surgical or medical problem can vary widely.

That's why fixed-fee packages for medical services have been a focus of heated discussion. The government hopes fixed-fee packages can increase fee transparency in private health care, and encourage people to join the government's proposed voluntary medical insurance scheme.

Any model of fixed-fee medical packages is about risk-sharing but, in theory, there is no change in private doctors' income in the long run.

But private doctors are not receptive to the idea. One private cardiologist was quoted as saying that with the fixed fees, 'doctors won't be rewarded for explaining more to patients'. Medical Association president Dr Choi Kin said, 'They will damage clinical autonomy and if all the costs are fixed, doctors' hands are tied, and they can't deliver good quality care.'

Are they saying that if they don't have the freedom to charge, they can't do their best for the patients?

The reality is that fixed-fee packages take away their chance to put an extra price-tag on every little thing they do for their patients. When I was a consultant for a medical insurance company, it was not unusual for me to come across claims of thousands of dollars for 'bedside tests' such as the 'tilt test' and 'Tensilon test'. Though uncommon and time-consuming, these tests should be part of the physical examination and should not have been extra charges.

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