Hong Kong health reform expands fee waivers, 95% public subsidy maintained
Hong Kong's public healthcare fee reform has expanded medical fee waivers to potentially 2 million people, with over 300,000 applications approved. The government maintains 95% subsidy for public services, while emergency department attendance dropped 0.9% in the first nine months of the year.
Hong Kong's Secretary for Health, Lo Chung-mau, said the public healthcare fee reform has significantly expanded the coverage of medical fee waiver mechanisms, with the number of potential beneficiaries rising from about 900,000 to approximately 2 million people. As of September 30, the Hospital Authority had received 331,951 applications for fee waivers, with more than 300,000 approved — an approval rate exceeding 90 per cent. The number of patients granted full fee waivers increased from fewer than 14,000 per year previously to more than 250,000, reflecting the policy's aim to redirect resources toward poorer patients.
In a written reply to a Legislative Council member's query, Lo said the reform has guided patients to use emergency departments more appropriately. In the first nine months of this year, the Hospital Authority's 18 emergency departments recorded over 1.4 million attendances, a 0.9 per cent decrease from the same period last year. Among these, category 4 and 5 cases — semi-urgent and non-urgent — fell by 6.8 per cent, with non-urgent cases dropping 17.5 per cent, showing the reform's effectiveness in diverting non-urgent patients.
Patients in categories 1 and 2 — critical and emergency — received full exemption from emergency department fees and were given priority treatment, achieving full compliance. The rate of category 3 cases receiving treatment within 30 minutes rose from 82 per cent to 88.4 per cent, indicating improved service efficiency for urgent patients after resource reallocation.
For serious and chronic illnesses, the reform introduced an annual fee cap of HK$10,000 without a means test, providing comprehensive protection for patients with serious or long-term conditions to prevent medical impoverishment. As of September 30, 20,655 patients had been approved under this mechanism.
Lo said the government still subsidises 95 per cent of public medical services, with patients' co-payments accounting for a very low proportion. Although the fee reform can increase revenue, this is partially offset by the significant expansion of fee waivers and the annual cap mechanism. He noted that since the reform has been implemented for less than a year, and the impact of the annual cap on service usage and payments remains to be seen, it is difficult to fully and accurately assess the overall financial impact on the Hospital Authority at this stage.
