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The Politics of Health Finance Reform in Hong Kong

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International Journal of Public and Private Healthcare Management and Economics, 1(2), 17-25, April-June 2011 17

The Politics of Health Finance Reform in Hong Kong
Raymond K. H. Chan, City University of Hong Kong, Hong Kong

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. Keywords: Health Finance, Health Policy, Health Services, Hong Kong, Public Health Services

The earliest public health services in Hong Kong were mainly devoted to combating communicable diseases. As the government was largely unresponsive to demands for further services, the gap in provision was filled by traditional Chinese medical practitioners and hospitals operated by local philanthropic organizations. It was not until the late 1950s that the government expanded its role and investment in health care. During the past five decades, a system of service provision has developed with a clear division of labour: the private sector oversees primary health care, and the public sector is responsible for the more expensive secondary and tertiary health care services. In terms of

DOI: 10.4018/ijpphme.2011040102

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