Opinion | For a lasting healthcare fix, Hong Kong must look beyond the symptoms

Hong Kong’s plan to reduce public healthcare subsidies from 97 per cent to 90 per cent by 2030 represents a significant shift in one of the world’s most heavily subsidised systems. While the Health Bureau portrays this as a necessary realignment, the reform warrants careful consideration as there are far-reaching implications for healthcare equity and access.

The most immediate concern is that the increased costs will deter patients from seeking timely treatment. Healthcare decisions are rarely made with perfect information – patients can struggle to distinguish between symptoms requiring immediate attention and those that can wait.

Officials argue that some patients exploit accident and emergency (A&E) departments for treatment to minor ailments that could be handled elsewhere. This accurately identifies a symptom while missing the underlying pathology: Hong Kong’s lack of accessible primary healthcare alternatives.

Despite the government’s 2022 Primary Care Blueprint promising district health centres and better coordination, implementation has proceeded at a glacial pace. The blueprint noted that less than 20 per cent of public healthcare spending was directed at primary care, compared with over 80 per cent on specialist and hospital services, creating a system that funnels patients towards hospitals.

Chief Executive John Lee Ka-chiu’s policy address last year acknowledged the need to strengthen public healthcare, but reforms still appear to address symptoms rather than causes.