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40th Anniversary Celebration
About HKCFP > President’s Message

May 2018

On 26th April I made a whirlwind visit to Beijing to attend the Chinese Medical Doctor Association (CMDA) 2018 General Practitioner Training Forum. As we all know China is embarking her ambitious programme of training enough Family Doctors to meet the demand in 2030. This was a good exchange and we shared the training programmes of China, USA, Canada and Australia.

Dr. Lau Ho Lim represented our College and delivered the talk on Hong Kong higher training programme. I was involved in a subcommittee to discuss the specialist training and the timing of implementation. My feeling is China has the determination to improve the training and standard of her healthcare system and is trying hard to meet the international standard.

On 22th April I was invited by Dr. William Ho and Dr. Ares Leung to talk at Multi-specialty Medical Mega Conference 2018 Lunch Symposium on “Insurance- Game Changer in Healthcare”. At the same forum were Mr. Fong Ngai, Deputy Secretary for Food and Health Bureau and representatives from private hospital and Hong Kong Medical Association.  With the imminent implementation of Voluntary Health Insurance Scheme (VHIS) this year, medical insurance is a big topic to chat about.

Most of you may not know that I am the medical consultant of two insurance companies in Hong Kong. My topic was “Mutual understanding for success in the era of third-party payment”.The objectives of VHIS are to enhance the protection level of hospital insurance products; to provide the public with additional choice of private healthcare services through hospital insurance; and to relieve the pressure on public healthcare system. If VHIS is purely to alleviate the financial burden of healthcare by the Government, it is already a failure to start with. If it is to enhance the better health of the Hong Kong people, this is another failure without the involvement of Family Physicians. This scheme is for private in-patient hospital insurance and is subject to abuse without the gatekeeping role of Family Physicians. We strive to keep patients out of the hospital and less money out of their pocket. The tax deduction ceiling is capped at $8,000 and this is hardly any financial incentive to buy this insurance product.

So what is Third Party Payment. Eligible health service expenses are paid to the healthcare providers, i.e. doctors and hospitals by a third party, i.e. insurance companies. Usually this is an employer-provided medical insurance. The objective of the insurance company is to provide convenience to patients with easy claim and reimbursement process and secondly to benefit the employer with cost containment. The common exclusions are pre-existing conditions and congenital disorders.

The figures from Insurance Authority showed the medical insurance industry’s claim paid/ gross premium ratio increased from 67% in 2012 to 72% in 2017. Over the past two years, the insurance companies are hardly making a profit and some are even in red with this claim ratio at 72%. The Government advertises that the standard yearly premium is HKD4800 on standard hospital room. One of our good Chinese idioms is “Wool comes from sheep’s back”. There is no such thing as free lunch or subsided lunch. The Government thinks the profitability of insurance companies is not its concern. Be realistic, you and I will not continue to run a business that is at loss year after year. I am sure the actuarist will come up with a much higher premium.

The trend at the moment is medical cost inflation which causes the insurance companies to encourage the use of day care centres for minor operation in order to minimize the hospital cost. Patient’s medical insurance benefit is not sufficient to cover the final medical cost and therefore the out of pocket cost from patient increases. Ultimately the higher premium becomes less attractive and the patients will go back to Hospital Authority. This is a vicious cycle!

To celebrate the World Family Doctor Day on 19th May this year, the new “My Family Doctors 3” TV Drama will start its first episode on this day at RTHK 31 station. An interview column on Headline Daily about “One Person, One Family Doctor” will publish on 18th May. Dr. Ngan Po Lun of Public Education Committee will appear at RTHK programme精靈一點 to promote the World Family Doctors Day and the new TV Drama on 18th May.

This day is to highlight the role and contribution of Family Doctors in health care systems around the world. It is a wonderful opportunity to acknowledge the central role of our specialty in the delivery of personal, comprehensive and continuing health care for all of our patients. We celebrate the progress being made in Family Medicine and the special contributions of Family Doctors not just in Hong Kong but globally. We are proud of our profession and this very day is the time to savour our commitment and success

Dr. Angus MW CHAN