The Politics of Health Finance Reform in Hong Kong

Author(s):  
Raymond K. H. Chan

Since the late 1950s, Hong Kong’s public health services have increased. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represented different, and even conflicting, values and interests. This paper describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.

Author(s):  
Raymond K. H. Chan

Since the late 1950s, Hong Kong’s public health services have increased. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represented different, and even conflicting, values and interests. This paper describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.


Author(s):  
Raymond K. H. Chan

Hong Kong's public health services gradually developed since the 1950s. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and has subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represent different, and even conflicting, values and interests; and eventually can only end up with a limited voluntary health insurance scheme. This chapter describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.


Author(s):  
Raymond K. H. Chan

Hong Kong's public health services gradually developed since the 1950s. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and has subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represent different, and even conflicting, values and interests; and eventually can only end up with a limited voluntary health insurance scheme. This chapter describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.


Author(s):  
Raymond K. H. Chan

Since the late 1950s, Hong Kong's public health services have increased. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and has subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represent different, and even conflicting, values and interests. This chapter describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.


Author(s):  
Raymond K. H. Chan

Since the late 1950s, Hong Kong’s public health services have increased. They are mainly funded by taxes, supplemented by minimal user fees. In the late 1980s, the government recognized the limitations of this financing model and has subsequently proposed alternative methods of funding. Their proposals have been rejected by various stakeholders, who represent different, and even conflicting, values and interests. This chapter describes the development of health services and the debates that have surrounded health financing since the late 1980s. It shows that the health finance debate in Hong Kong is not a simple issue that can be tackled by rational planning; instead, it is a complex consequence of welfare politics in an increasingly mobilized society.


2020 ◽  
Vol 14 (1) ◽  
pp. 17-28
Author(s):  
Ditha Prasanti ◽  
Ikhsan Fuady ◽  
Sri Seti Indriani

The "one data" policy driven by the government through the Ministry of Health is believed to be able to innovate and give a new face to health services. Of course, the improvement of health services starts from the smallest and lowest layers, namely Polindes. Starting from this policy and the finding of relatively low public health service problems, the authors see a health service in Polindes, which contributes positively to improving the quality of public health services. The health service is the author's view of the communication perspective through the study of Communication in the Synergy of Public Health Services Polindes (Village Maternity Post) in Tarumajaya Village, Kertasari District, Bandung Regency. The method used in this research is a case study. The results of the study revealed that public health services in Polindes are inseparable from the communication process that exists in the village. The verbal communication process includes positive synergy between the communicator and the communicant. In this case, the communicators are village midwives, village officials, namely the village head and his staff, the sub-district health center, and the active role of the village cadres involved. In contrast, the communicant that was targeted was the community in the village of Tarumajaya. This positive synergy results in a marked increase in public services, namely by providing new facilities in the village, RTK (Birth Waiting Home).   Kebijakan “one data” yang dimotori oleh pemerintah melalui Kementerian kesehatan diyakini mampu membuat inovasi dan memberikan wajah baru terhadap layanan kesehatan. Tentunya, perbaikan layanan kesehatan tersebut dimulai dari lapisan terkecil dan terbawah yakni Polindes. Berawal dari kebijakan tersebut dan masih ditemukannya masalah pelayanan kesehatan publik yang relatif rendah, penulis melihat sebuah layanan kesehatan di Polindes, yang memberikan kontribusi positif dalam peningkatan kualitas layanan kesehatan masyarakat. Pelayanan kesahatan tersebut penulis lihat dari perpektif komunikasi melaui penelitian Komunikasi dalam Sinergi Pelayanan Kesehatan Publik Polindes (Pos Bersalin Desa) di Desa Tarumajaya, Kecamatan Kertasari, Kabupaten Bandung ini dilakukan. Metode yang digunakan dalam penelitian ini adalah studi kasus. Hasil penelitian mengungkapkan bahwa pelayanan kesehatan publik di Polindes, tidak terlepas dari adanya proses komunikasi yang terjalin di desa tersebut. Proses komunikasi verbal tersebut meliputi sinergitas positif antara pihak komunikator dan komunikan. Dalam hal ini, komunikator tersebut adalah Bidan Desa, Aparat Desa yakni Kepala Desa beserta staffnya, Puskesmas tingkat kecamatan, serta peran aktif dari para kader desa yang terlibat. Sedangkan komunikan yang menjadi target adalah masyarakat di desa Tarumajaya. Sinergitas positif tersebut menghasilkan peningkatan pelayanan publik yang nyata, yaitu dengan adanya penyediaan fasilitas baru di desa, RTK (Rumah Tunggu Kelahiran).


2015 ◽  
pp. 1159-1176
Author(s):  
Raymond K. H. Chan ◽  
Kang Hu

This chapter analyzes the issue of primary health care utilization in Hong Kong and introduces the case of Hong Kong where a special division between public and private sectors has developed in the field of primary health services. The chapter argues that in the foreseeable future, it is likely that the division of health care between the public and private sector will be maintained. In recent years, more and more individuals and families have purchased private health insurance so as to gain more options. The idea of universal health insurance was rejected by the public in recent consultations; the current alternative is government-regulated private insurance. Although private primary health services will continue as usual in the near future, public primary health services should be maintained or even expanded. Given the costliness of private services (especially specialist services), it is recommended that more resources should be invested in corresponding public health services.


Author(s):  
S. M. A. Hanifi ◽  
Aazia Hossain ◽  
Asiful Haidar Chowdhury ◽  
Shahidul Hoque ◽  
Mohammad Abdus Selim ◽  
...  

Abstract Background The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of CC services is still very low. Evidence indicates community score card is an effective tool to increase utilisation of services from health facility through regular interface meeting between service providers and beneficiary. We investigated whether community scorecards (CSC) improve utilisation of health services provided by CCs in rural area of Bangladesh. Methods This study was conducted from December 2017 to November 2018. Three intervention and three control CCs were selected from Chakaria, a rural sub-district of Bangladesh. CSC was introduced with the Community Groups and Community Support Groups in intervention CCs between January to October 2018. Data were collected through observation of CCs during operational hours, key informant interviews, focus group discussions, and from DHIS2. Utilisation of CC services was compared between intervention and control areas, pre and post CSC intervention. Results Post CSC intervention, community awareness about CC services, utilisation of clinic operational hours, and accountability of healthcare providers have increased in the intervention CCs. Utilisation of primary healthcare services including family planning services, antenatal care, postnatal care and basic health services have significantly improved in intervention CCs. Conclusion CSC is an effective tool to increase the service utilization provided by CCs by ensuring community awareness and participation, and service providers’ accountability. Policy makers and concerned authorities may take necessary steps to integrate community scorecard in the health system by incorporating it in CCs.


Author(s):  
Frank Nyonator

Chapter 19 describes the journey that Ghana has been on since 2003 as it sought to bring together existing community based health insurance schemes of many sorts within a single national framework, which offered a package of care to all its citizens—however poor and from whatever background. It covers the challenges in integrating the existing schemes, in applying different aspects of the policy, in funding, and in reaching the poorest. It also discusses how the government has changed and with it some aspects of policy, and how, after 10 years, around a third of the population are active members of the National Health Insurance Scheme and there is a foundation in place for continuing the journey to ensure that health services are available to everyone as the country continues to grow and prosper.


Author(s):  
I. M. Sheshi ◽  
A. Ahmed ◽  
M. D. Sani ◽  
Y. F. Issa ◽  
B. E. Agbana

Introduction: Community based health financing mechanism is referred to as a process whereby household in a community finance or co finance the recurrent and capital cost associated with a given set of health services thereby also include management of financial scheme and organization of health services. Iccm as a strategy to providing integrated case management services for two or more illness including diarrhea, malaria, pneumonia among children from two to upto five years. It is a community approach where lay persons are trained on management of the three diseases. This approach is being funded by foreign donor. However, there was stipulated period in which this support would elapsed and the support from the state Government may not be feasible. In an attempt to source for financing of iccm, this study aim at determining the willingness of the caregiver to use Community financing approach through payment of Premium to finance this community intervention (iccm). The concept of willingness to pay is maximum price a consumer is willing to pay for a given product or services. Materials and Methodology: A descriptive Cross sectional study was carried out among four hundred respondents that were selected using Multi stage sampling technique. Data was collected, coded and entered into a computer. Analysis was carried out using SPSS. Chi Square and logistic regression was used as a test of significance. Level of significance was set at Pvalue less than 0.05. Results: Twenty two percent of the respondents had good knowledge of iccm activities. Less than half of the respondents 41.3% were satisfied with iccm activities. Majority of the respondents 93.3% were willing to pay. Out of this, half of them 50.0% said they could only afford to pay less than 1000 naira per annum and 72.8% said the convenient time to pay was during the harvesting time. Factors influencing willingness to pay include Age, marital status and income level ( Pvalue <0.05). Knowledge and level of satisfaction were not influencing factors. The predictor of willingness to pay are aged 38-47 years and income of less than 5000 naira. Conclusion and Recommendation: There was willingness of the respondents to contribute for financing and sustainability of iccm in Niger State but the amount the majority of them were willing to pay was less than 1000 naira which might not able to sustain the iccm activities. There may be need for further research to determine amount needed for the annual activities and hence sustainability of iccm. The Government should show much responsibilities toward financing of iccm. Bi-apartite arrangement could be made between State Government and the Communities with iccm in place on how to share some responsibilities of iccm activities.


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