Can you rely on Hong Kong’s Public Healthcare System?

CCW Global has always championed the availability of Hong Kong’s government run healthcare services. Provided at extremely low costs, Hong Kong’s public healthcare system is able to offer a very high level of care, which in turn sees private medical insurance become a luxury product to local residents.

Why spend thousands of dollars a year on a health insurance policy when you can receive the same services at a public hospital or clinic virtually free of charge?

At CCW Global we have always stated that private health insurance is not a necessity for Hong Kong residents. While there are benefits to having medical cover and using the private healthcare system, the standard of care on offer is no different to that being offered by the Hong Kong Hospital Authority.

Private care generally sees patients receiving treatment faster than in the public system, and the inpatient accommodations are often far nicer with a better quality of food than at a government hospital, but with regards to the treatment available there is often no substantial difference.

A system under stress

In the last two years a string of medical blunders have seriously eroded the confidence we once had in the public healthcare system. From nurses forgetting medication leading to patients dying, unsupervised procedures being performed by trainees, to the removal of a patient’s reproductive organs without their consent, cracks are starting to appear within the Hospital Authority.

It should be noted that in 2018, well before the emergence of the Covid-19 Coronavirus, there were serious concerns about a manpower shortage within the public healthcare system. A staff turnover rate of 5.7 percent, with a 10 percent turnover rate of doctors in more specialized fields, means that doctors and nurses were under a severe amount of stress due to their workload before Hong Kong started to experience the additional pressure of the pandemic situation.

While the private medical system has roughly 10 percent of the city’s patients, it has over 60 percent of Hong Kong’s doctors. Public facilities account for 90 percent of Hong Kong’s medical care, but only employ 40 percent of the total number of workers. This means that there will always be a capacity shortfall within the public system with regards to manpower, and that mistakes are going to happen as a consequence. More duties, longer working hours, and less time to manage existing patients sees the number of serious medical blunders occurring within the Public Healthcare system increasing.

This manpower issue also has a direct impact on the services which hospitals and clinics are able to offer. Fewer workers will, inevitably, mean less space for care. In fact, floor space at many hospitals is vastly underused, and fewer beds are being offered to inpatients as a consequence. This in turn leads to fewer people being treated at any given time, lengthening the overall waiting period for care, creating more demand and more stress on the public healthcare system as a whole.

Then we ran into the Covid-19 Coronavirus.

Covid-19 brings its own unique challenges

The unique pandemic situation caused by the Covid-19 Coronavirus, and the extreme isolation and quarantine measures needed to effectively combat the disease while treating patients, has only highlighted the shortfalls of the public healthcare system.

With only so many doctors and nurses in the public system, and the fact that hospitals are able to cope with fewer patients that they should, compromises are being made around the pandemic that are leading to deadly outcomes.

In the first 10 months of 2020 Hong Kong saw 136 infections of the deadly fungus Candida Auris, compared to 20 cases during 2019. Candida Auris is a multiple drug resistant fungus that has a mortality rate of 30 to 60 percent in people infected, according to the CDC. As of October 24 2020, there were 1,394 cases of Candida Auris globally, so it is concerning that Hong Kong has experienced a tenth of that number in cases this year.

Further concern should be realized with regard to the many unknowns from this fungus and the fact that it is able to spread through environmental contact, contamination of equipment and surfaces, and person-to-person. Although the fungus has mainly affected people aged 60 or over, it has been found to infect people as young as 20.

While the standard course of action for a Candida Auris outbreak is to separate and isolate the infected person due to the Covid-19 pandemic this has proven to be increasingly difficult. As Covid patients need to be quarantined in order to stop the spread of the disease isolation units at public hospitals have reached capacity. This has forced medical providers to place individuals infected with Candida Auris in ward settings, increasing the potential spread of the fungus – wards are not hermetically sealed isolation units, no matter what stop-gap measures are created.

According to Dr Raymond Lai of the Hospital Authority, it is possible to spread the fungus through shed skin cells and because older people are at risk this could create a disaster situation in hospitals and nursing homes. This is especially true considering Covid-19 is more dangerous for older people or individuals suffering from pre-existing medical conditions, and the introduction of a super fungus that is immune or resistant to multiple treatment options severely increases the risk of death in the population at large.

While Hong Kong’s public healthcare system does have the capability of providing great medical care, at this point in time with all factors considered choosing to use the public healthcare system may be the riskier treatment option in the city. With mistakes running rampant and the Hospital Authority fighting two serious and deadly disease outbreaks, the allure of affordable but quality healthcare may be diminishing.

There is the private healthcare option

As stated in the Healthcare Asia Magazine article we cited above, Hong Kong’s private medical system is responsible for roughly 10 percent of the treatment burden while having around 60 percent of the city’s doctors. There is, obviously, far more capacity in the private healthcare system and with the standard of care being roughly equivalent, the primary reason for opting to use private medical care in Hong Kong is ease of accesses and speed of treatment.

There is, however, the issue of cost.

The major reason that Hong Kong’s private healthcare system only shoulders 10 percent of the overall treatment burden is the fact that it is extremely expensive. In fact, Hong Kong is second only to the United States of America in terms of how much it costs to receive treatment when it comes to private care. This means that, for many people, treatment at a private hospital or clinic is not realistic – it simply costs too much! Unless, that is, they have private health insurance.

Private Hong Kong health insurance is a great way to ensure that you are able to access quick healthcare as and when you need it, with the assurance that your doctor will have the time and ability to properly pay attention to your case.

It does come with a premium cost, however, although this is far lower than the cost of treatment for an inpatient condition at a hospital. Plan premiums are generally rated based on your age and your geographical area of coverage, so policies are usually cheaper for younger people with a more focused coverage area. Despite this, the Hong Kong public healthcare system is not in as good a place as it was 5 or 6 years ago, and the cost of a private health insurance policy may actually be a very good investment in light of the worrying conditions and suspect outcomes being produced by government hospitals.

Hong Kong’s Hospital Authority is world renowned at offering low-cost, high-quality healthcare. Unfortunately, both the systemic issues, and the myriad problems presented by 2020 as a year, have created an environment where the shortfalls within the public system are exposed. This leaves a worrying scenario where we are unable to rely on the public healthcare system for fear of (for example) being exposed to a deadly multidrug-resistant super fungus because proper containment was not available, or because a trainee nurse made a mistake.

As worrying as life is right now, CCW Global can help you make sense of your healthcare and health insurance options with our guarantee that you will not be pressured into buying anything. Contact us today for a free, no-risk, no-obligation consultation with one of our expert insurance brokers, and let us simplify your insurance.