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Public or Private? A Guide to Healthcare in Hong Kong

Navigating Hong Kong’s healthcare scene can be a headache. Although excellent public healthcare is available to residents at low costs, this system goes hand-in-hand with long waiting times and a reduction in comfort and privacy. Many Hong Kongers, especially expats, therefore opt to go private, benefiting from high-quality equipment, familiar doctors, and cushy accommodation. However, all this luxury doesn’t come cheap. We weigh up the pros and cons of a system of two halves.

Find out about:

How it Works | Problems | Waiting Times
Government Health ReformHong Kong vs. United Kingdom
Hong Kong vs. United States | Choosing Private or Public | Public Clinics
AccommodationMaternity Packages | Surgery Prices | Health Insurance


Gleneagles Hospital

Introduction

The Hong Kong healthcare system is composed of two sectors: a private track and a government sponsored public track. The private sector offers numerous options and luxurious perks, but comes at a very high price. The public sector, subsidised by the Hong Kong Government, is provided to eligible citizens at a very low fee. However, the public sector faces a number of growing problems, including overcrowding, long waiting times, and excessive bureaucracy.

In order to address problems within the public sector, the Hong Kong Government launched a healthcare reform in 2008. Split into two sections, it aimed to enhance public-private partnerships and shorten waiting times, among a whole plethora of other promises. Not much progress has so far been made and, as a result, private healthcare in Hong Kong remains expensive.

The true cost and quality of the healthcare services offered in Hong Kong is made clear in comparison against those of the United Kingdom and the United States. In Hong Kong, unlike in many other countries, private healthcare is an optional luxury, and not a necessity. At the core, the medical standard for both public and private sectors is quite similar. This makes choosing between the public and private sector extremely difficult, and there are many factors to consider, including availability, resources, facilities, and services.

Furthermore, the exact prices of procedures and surgeries within Hong Kong’s private hospitals are extremely difficult to determine. There are numerous mandatory and/or optional charges that can amount to a very hefty price tag. This non-transparency of private service services further complicates the act of choosing between the public and private sector, as direct price comparisons cannot be made.

Despite the cost confusion, one thing that holds true is that the luxuriousness of private healthcare also brings about a financial burden. Since private healthcare prices are extremely high, those who go for this option should consider health insurance. Generally, insurance plans can be tailored to fit specific needs; with higher premiums normally resulting in higher coverage received. However, there are many adjustments that can be made (such as outpatient plans, area of coverage, dental and deductibles) that can drastically alter both the premium and coverage.


The Hong Kong Healthcare System – How it Works

The Private System

Hong Kong has 11 registered private hospitals. While prices for private treatments and procedures are significantly higher than those at government-run facilities, the private system boasts many luxurious perks, such as deluxe rooms and customer-friendly workers.

The Public System

Managed by the Hong Kong Hospital Authority, Hong Kong’s public sector has 42 public hospitals, 47 specialist out-patient clinics, and 73 general out-patient clinics, all organised into seven clusters according to their locations.

Since the Hong Kong public healthcare system is subsidised by the Government, quality health services are provided for eligible residents at a very low cost. A visit to a public hospital in Hong Kong will come at a fraction of the cost at a private hospital. A few common Hong Kong public hospital fees are listed in the chart below:



The Hong Kong healthcare system provides high quality medical services for “eligible persons” for a very low cost. To be “eligible”, you must be:

  • Holder of Hong Kong Identity Card issued under the Registration of Persons Ordinance
  • A child under 11 years of age with Hong Kong resident status
  • Other persons approved by the Chief Executive of the Hospital Authority

This sector acts as a safety net for the whole community, ready to “catch” those who cannot afford private healthcare services.


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 Problems the Hong Kong Public Healthcare
System Faces

The public healthcare system, featuring low costs and exemplary standards of care is, unfortunately, unsustainable and facing a number of growing challenges.

Unstable Funding

Each year, the Hong Kong Government devotes a considerable portion of its revenue to subsidising public healthcare (around 17%). This percentage increases every year, and from 2010 to 2015 it rose by 50%. Although the Government has been successful in maintaining high quality public healthcare for a number of years, the estimated future costs are unsustainable.

In 2012 alone, the Government spent around HK$45 trillion (or US$5.8 billion) funding the public healthcare system. On the whole, Hong Kong spends about 5.2% of GDP on healthcare.

The following chart demonstrates the fee that patients pay, the actual cost the Government pays, and the percentage of services that are subsidised within the public healthcare system:

The cost of each procedure is significantly higher than the fees paid by patients, and the percentage of the cost subsidised by the Government is incredibly high. Such a large percentage is unfeasible for the Hong Kong Government to continue to sustain, and therefore the current public healthcare funding is unstable.

Aging Population


Like many other countries, Hong Kong has a rapidly aging population. The ratio of the working-age population (15 – 64) to the elderly population (65+) is currently at 6:1. By 2030, it is projected to reach 4:1, and by 2033, it will decrease to 3:1. As the population ages, the elderly will require more healthcare services, and therefore more funds will have to be allotted towards them. Additionally, as the population ages, the working-age population will decrease, therefore decreasing the number of taxpayers. As the cost of public healthcare creeps higher and higher, the burden will fall on an increasingly smaller group.

Waiting Times

Since services and procedures are offered at such low costs, public hospitals are constantly crowded, busy, and overburdened. Patients who don’t have emergencies or time-sensitive illnesses often have their appointments rescheduled. These practices can create a waiting period of a few weeks, months, or even years depending on the procedure.

The following chart details the average waiting time for different procedures at the Ambulatory Care Center at Tuen Mun Hospital.

Due to the increasing demand for supply and the growing waiting times for procedures and services, the Hong Kong Hospital Authority placed a triage system at specialist out-patient clinics. Medical appointments are arranged according to the urgency of the patient’s clinical condition at the time of referral. Patients are classified into three categories:

  • Priority 1 (urgent)
  • Priority 2 (semi-urgent)
  • Routine category

The Hospital Authority arranges for doctors to attend to priority 1 and 2 as soon as possible. However, for the patients in the routine category, the waiting time is much longer, sometimes more than two years.

Rising Costs of Medical Technology



Medical technology refers to procedures, equipment, and processes by which healthcare services are delivered. This includes medical and surgical procedures, drugs, and medicinal items, medical devices (like CT scanners) and support systems (such as electronic medical records). There is very little in the field of medicine that is not affected by new technological developments.

Today’s medical technology is more effective, more advanced, and incurs much higher costs than ever before. The demand for technological diagnostic facilities is ever increasing, and innovative medical advances push the price tag up every year (costs for diagnostic tests increase at an average annual rate of 7%). Hong Kong’s medical machines and facilities are modern, up to date, and constantly being renewed. These machines are costly to acquire and need to be consistently upgraded, which then increases the burden on government funds each year.


The Hong Kong Government’s Health Reform

In response to the problems in the current healthcare system, the Government initiated a reform programme that was divided into two stages:

Stage One

Launched in 2008, stage one of the healthcare reform focused on revising the public healthcare sector. Its main objectives were to:

  1. Enhance Primary Care
    Primary care is defined as the first contact between patients and doctors (e.g. first consultations and meeting with physicians and general practitioners). By focusing on primary care and taking necessary preventative measures, the demand for expensive specialist-led hospital care can be reduced.
  2. Promote Public-Private Partnerships
    By negotiating a contract between the public and private sectors, both divisions can benefit from this partnership. The two sectors will become more interconnected, which in turn will foster cross-sector training. Through this partnership, the private sector will also gain a greater number of patients, which will help alleviate the public sector’s burden.
  3. Develop Electronic Health Record (eHR) Sharing
    The electronic health record is a consolidated electronic file that contains a patient’s general information, medical history, and any health-related details. By providing lifelong health records of individual patients, switching between different levels or different sectors of care will be smoother and easier.
  4. Strengthen Public Healthcare Safety Net
    The Hong Kong Government will continue to subsidise public healthcare services and provide an essential safety net for the population (especially those who lack the means to pay for their own healthcare). The Government also aims to improve the current public healthcare (e.g. tackling long waiting times).

Stage One – Reform Update

In 2010, within two years of launching the healthcare reform, the Hong Kong Government has increased the health budget from $30.5 billion to $36.9 billion, and invested over $15 billion in healthcare infrastructure. The progress within each objective is described below:

  1. Enhance Primary Care
    The Primary Care Working Group (composed of practitioners from both public and private sectors, as well as patient representatives) has formulated and established a new development strategy. This will then be taken forward by the Primary Care Office.
  2. Promote Public-Private Partnership (PPP)
    A number of pilot projects with the aim of delivering healthcare services through PPP are underway (e.g. purchase of private healthcare services and direct subsidisation of patients for private healthcare etc.). These projects will be closely monitored.
  3. Develop Electronic Health Record (eHR) sharing
    The eHR Office, IT experts from the Hospital Authority and the private sector are all working together to implement eHR programmes.
  4. Strengthen Public Healthcare Safety Net
    The Government has increased funding for the Hospital Authority (from $28.0 billion to $49 billion, as of 2015). In addition, $1 billion has been donated to the Samaritan Fund to help those in need.

Stage Two – Health Protection Scheme

Also in 2010, with stage one underway, the Hong Kong Government decided it was time to launched stage two of the healthcare reform. Also known as the Health Protection Scheme (HPS), stage two is focused on regulating private health insurance. Operating on a voluntary basis, the Health Protection Scheme encourages individuals who are able and willing to subscribe to private health insurance to do so. Its main objectives are as follows:

  1. Provide Choices
    The HPS aims to keep options open to those who are willing to pay for private health insurance and private healthcare services.
  2. Shorten Waiting Times
    Relieve public queues by enabling more people to choose private services, and focus public healthcare on target groups.
  3. Stay Insured
    Enable those with health insurance to stay insured and continue to make premium payments at older age, and meet their healthcare needs through private services.
  4. Consumer Protection
    Enhance transparency, competition for consumer protection in private health insurance and private healthcare services.

The results and progress of the Health Protection Scheme are yet to be seen. With a multitude of endless consultation documents and plans, one might have expected a drastic improvement or even a difference in both the public and private Hong Kong healthcare system. While the Government is making progress in reforming the Hong Kong healthcare system, the average person in Hong Kong remains largely unaffected by these developments.

The healthcare reform hasn’t changed much in Hong Kong. It doesn’t look like it will either, at least not in the near future.


Comparing Hong Kong’s Health Care System to
Other Countries

The current setup of Hong Kong’s healthcare system can more clearly be digested in comparison to those of two other countries: the United Kingdom and the United States. When juxtaposed against two well-known extremes (a largely public system and a mostly private-based system), the healthcare setup in Hong Kong is more easily understood.

The United Kingdom

The United Kingdom is well known for its National Health Service (NHS), a government sponsored universal healthcare system. UK residents are entitled to services provided by the publicly funded NHS, but have the option to buy private health insurance as well.

The National Health Service is free at the point of need, and is paid for by general taxation (about 19% of income tax goes towards healthcare). Currently, the NHS deals with over 1 million patients every 36 hours.

A 2014 Commonwealth fund report named the UK’s healthcare system as the most efficient in the world. “The UK has relatively short waiting times for basic medical care and non-emergency access to services after hours, but has longer waiting times for specialist care and elective, non-emergency surgery.”

Hong Kong vs. United Kingdom

With the healthcare services available via the NHS, it is understandable that the UK’s private sector is much smaller than the public sector, although it is growing. This is compared to Hong Kong, where although public health services are offered, a larger percentage of residents now opt for private healthcare.

In the United Kingdom, approximately 11% of the population have some form of private medical insurance (as of 2014). According to The King’s Fund report, individual purchase of private medical insurance in the United Kingdom is continuing in its long term decline. This is compared to Hong Kong, where 2.42 million people have private medical insurance, which constitutes around 34% of the population. Based on the figures and percentages above, it can be concluded that residents in the United Kingdom are much more dependent on the public system, and that private medical insurance is not as prominent as it is in Hong Kong.

The chart below compares the prices of certain medical procedures in the UK. Hong Kong and different countries.

All prices are in HK$** and only include the hospital and physician fee, no additions (e.g. Epidural charges, midwife, spouse presence, any complications, and so on).

The most expensive column, highlighted in yellow, lists the prices found in the private sector of Hong Kong’s healthcare system. This is compared to the adjacent column, in which it is clear to see that the cost of the same procedures in the United Kingdom is considerably lower.

In comparison to the United Kingdom (a mostly public healthcare system), Hong Kong boasts a larger percentage of people who opt for the private healthcare sector, and are therefore less dependent on government subsidised services. However, when comparing Hong Kong to a primarily private system (such as the United States), some different conclusions can be drawn.

The United States

The United States has the most expensive healthcare system in the world. Outside of a limited provision for old age and low income individuals, the United States provides almost no public healthcare offerings and therefore, American health services are largely private. As a result, a free market economy has developed, and prices are driven up by demand. Despite the open and competitive private system, the United States still spends more on healthcare than any other industrialised nation in the world.

Hong Kong vs. United States

Although Hong Kong spends less than the United States on healthcare, the Hong Kong Government is still able to provide public healthcare services, while the United States operates solely on private services. Since private healthcare is so much more prominent, the United States’ limited “safety net” doesn’t catch many of those who cannot afford necessary medical services.

However, when comparing the private sector of Hong Kong’s healthcare system to the largely private United States healthcare system, many similarities can be drawn:

  • Both systems are driven by demand and adhere to free market principles
  • No “standard” or set price regulates the system
  • Depending on various factors, such as the doctor’s credentials and experience and room type, prices can differ drastically

The following chart shows the price of certain medical procedures in the US, Hong Kong, and different countries around the world.

All prices are in HKS* and only include the hospital and physician fee, no additions (ex. Epidural charges, midwife, spouse presence, any complications, and so on).

Although Hong Kong prices for these medical procedures are higher than those in Spain, South Africa, or New Zealand, the cost of healthcare in the United States is significantly higher than in any other developed economies.

Hong Kong vs. United States (quality)

With such expensive healthcare in the United States, it is expected that the level of services, and therefore the general “healthiness” of the country, would be very high. However, with the exception of certain states, Hong Kong’s residents are generally much healthier than those of the United States.

The chart below compares the life expectancy and infant mortality rate between Hong Kong and the United States.

Screen Shot 2016-02-12 at 12

While the healthiness of a country cannot be accurately summed up by life expectancy and infant mortality rates, these data points do provide a good indication of a population’s general well-being. The figures above show that life expectancy for both males and females is higher in Hong Kong, while the infant mortality rate is also lower than that of the United States. Hong Kong’s life expectancy figures stand in eighth place globally (as of 2015), compared to the United States’ rank of 53rd.

However, unlike both the United Kingdom and United States, Hong Kong has both a prominent private and public health sector, often making the decision between private or public healthcare even more confusing and difficult.


Choosing Private or Public Healthcare Services

Generally, standards of care within Hong Kong’s public healthcare sector, or government subsidised services, are very high. Doctors, surgeons, and specialists, while perhaps not the top professionals of their field, are extremely skilled at handling medical procedures and services. The difference between the private and public sectors is slight, and unlike the United States, private healthcare services in Hong Kong are not a necessity, but an optional luxury.

While the price is the most glaring difference between public and private healthcare services, the following should also be considered:

Availability

Public
The high subsidisation rate and quality services offered by Hong Kong public hospitals continues to attract patients into the system, overburdening these facilities. Constantly bustling and full, non-emergency or non-time-sensitive issues, these hospitals are forced to rescheduled most primary appointments to a much later date.

The chart above shows the (already lengthy) current waiting time for certain procedures, which are expected to continue growing. Attending a public hospital will inevitably incur hours of queuing and an ever-increasing waiting time.

Private
Since the private sector provides care for much fewer patients, procedures can be conducted almost immediately, contrasting sharply with the situation in public hospitals. Long waiting periods are not usually seen in the private sector.

Resources and Public Clinics

Public
While the public sector boasts numerous hospitals and out-patient clinics, there is a lack of subsidised specialist clinics. For example, focusing solely on public dental clinics, the Hospital Authority manages 12 (of which just one is on Hong Kong Island and two serve the whole of Kowloon).

On March 10, 2013, the South China Morning Post reported on a group of elderly people queuing outside a dental clinic in the early hours of the morning. Due to the high cost of going to a private practice dental office, many are forced to endure a long and painful wait for a “consultation chip”.

An elderly resident told the paper, “It’s not even a proper check-up at the government dental clinics, you just go in and get the bad tooth taken out. If there are two, they pick the worse one and ask you to queue up again next day to take the second one out.”

As seen from the arduous waiting time that many patients endure, and the lacklustre treatment they sometimes receive, it is often said that the Hong Kong Public Hospitals have an insufficient number of resources and specialist clinics. Although this example only focused on one specialist, similar patterns are surfacing in other medical professional fields.

Private
Hong Kong has hundreds of private dentists, many more than in the public sector. Similar to availability in public hospitals, private clinics care for far fewer patients and, therefore, are able to attend to a patient’s medical needs sooner.

Getting to “know” your doctor

In addition to the number of resources and clinics, the professionals operating within such institutions are even more important. Visiting or consulting with a familiar doctor is an optional luxury that private healthcare may bring. At private clinics, the patient has the privilege of seeing the same doctor each visit, and there are certain benefits associated with that:

1. Medical History

Private: A doctor who is familiar with their patient’s condition is able to more specifically tailor the treatment to each individual’s needs. This includes:

  • Prescriptions – A consistent doctor will already know of any medications their patient is ingesting (this includes even vitamins), and will be able to modify treatment according to prior knowledge of how each patient reacts to certain drugs.
  • Medical Diagnostic Tests – A doctor who is familiar with a patient’s medical history may be able to waive certain medical diagnostic tests.

Public: A patient going to a public hospital or public clinics will be assigned to whichever doctor is on call and available. The chances of meeting the same doctor twice are very low. Therefore, the same advantages of going to a private doctor are not necessarily applicable:

  • Prescription – A new doctor will be foreign to a patient’s medical history, and may lack an in-depth understanding of their medical past. Unaware of all of the drug items their patient is ingesting, or how their patients react to prescriptions.
  • Medical Diagnostic Test – Such tests may be administered again (even if previously undertaken or unnecessary), as a new doctor lacks prior knowledge of a patient’s medical history.

An article published in the New York Times on May 2, 2011, details how important and cost-efficient familiar doctors are. Patient Mary Pat Dorsey asserted that Dr Sroka had saved her thousands of dollars in unnecessary trips to the emergency rooms due to his intimate knowledge of her medical history.

2. Comfort

Private: A personal doctor will know more about their patient’s everyday habits; information such as the area in which his patient resides, dietary habits, sleeping schedule, and hobbies etc. A private doctor may also be aware of life changes; these may include divorce, death in the family and/or relocation. When diagnosing a patient, these details can become extremely important.

Public: It can be extremely difficult telling a stranger such intimate details of your life, and many patients choose not to. However, such information can be vital.

3. Quality of Materials and Treatments

Private
Private clinics are often spacious, cushy, and lavishly decorated. In private services, the patient is the customer. Workers operate on a “patient-oriented” mind-set, and are often described as more polite and gentle.

Public
The world of public healthcare is quite different. Public hospitals are swarming with patients. In a place focused on efficiency, doctors can diagnose patients in under five minutes, and surgeons can perform routine surgeries “with their eyes closed”. Hospital workers deal with the same illnesses and procedures day-in and day-out.

Workers in public hospitals often have no choice but to present you with a “quick-fix” solution. They’ll give you medications to stop the pain, patch you up, and send you on your way. With so many in need, it’s all they have the time to do.

The difference between public and private care can clearly be highlighted through the example of an appendectomy (a standard, relatively simple procedure of removing a patient’s appendix). Although surgeons in both sectors can perform a routine appendectomy with minimal effort, there are discrepancies in treatment and quality, such as the type of materials used (quality of stitches and medication), the length and depth of the incision, and whether or not a visible scar remains.

While a middle-aged man may not mind a scar in his right lower abdomen, and therefore go with public services, a young women may, and therefore be willing to go to a private doctor and pay a higher fee in order to avoid scarring.

Although both the private and public sector can provide quality healthcare services, there are differences in the quality of materials used. The decision between public and private healthcare then rests upon what each individual is looking for.

4. Levels of Accommodation

Often, certain procedures will require a patient to remain in the hospital overnight. If you require in-patient treatment, the level of accommodation, or room types and offerings, should be factored into your decision between private and public.

Private
Certain suites at private hospitals are infinitely more extravagant than those in public hospitals. If it’s luxury you’re looking for, deluxe accommodation is available at private hospitals (albeit at an exorbitant price). The private hospitals in Hong Kong usually offer a range of rooms including general wards (3 – 6 beds), semi-private rooms (2 beds) and private rooms (single bed), while some hospitals even have deluxe suites. The four most luxurious hospital rooms in Hong Kong are listed below:

  • The Ellen Suite
    Hospital: Hong Kong Sanatorium & Hospital
    Price per night: HK$22,500 ($2,883 USD) 

Named in honour of the late Dr. Ellen Li, this private suite covers an area of over 2,000 square feet. Located on the 37th floor, the view from this suite is of the stunning Happy Valley skyline. Spacious and cosily decorated, the room features a sitting area with a 70 inch HDTV, an eight-person dining area, an open kitchen with refrigerator and microwave, another adjoining companion room with its own private lavatory and washroom, auto lights, touch screen control, local, Now TV and Satellite TV channels, free wireless broadband internet, a “magic eye” security system, and much more.

  • 36/F Suites
    Hospital: Hong Kong Sanatorium & Hospital
    Price per night: HK$12,000 ($1,538USD)

Located on the 36th floor of the Sanatorium, this swanky suite gives new meaning to the phrase “deluxe hospital accommodation”. Spacious and luxurious, this suite also overlooks the Happy Valley skyline. Although smaller and less lavish than the Ellen suite, it has its own sitting area, dining area, private washrooms, companion bed, HDTV, refrigerator, microwave, and more.

  • The “VIP Room”
    Hospital: Matilda International Hospital
    Price per night: HK$4,000 ($516 USD)

This room looks more like a nice hotel suite than a hospital room, with its crown moulding, private balcony, and room slippers. Perhaps the best part is that the catering is from the Shangri-La hotel chain!

Extreme decadence aside, even basic rooms in private hospitals are generally more appealing than those in public hospitals. The patient should decide whether the extra luxurious perks are worth the extra cost, especially expectant mothers booking maternity rooms.

Public
Public hospital accommodations sharply contrast with that of private hospitals. As a public patient, only general wards are available. A room contains numerous beds (ranging anywhere from 3-10). The price difference between private and public hospitals are made clear in the chart below. It shows the lowest possible cost of a single night in a private room (single bed):

Screen Shot 2016-02-12 at 12.46.27 pm

While private hospital rooms are starting to resemble hotel rooms, these rooms come with a very hefty price tag, even in that respect. Whether or not the extra cost is worth it depends entirely on the patient.


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Non-transparency of Prices – The Issue with Hong Kong Healthcare

It is near-impossible to obtain a pre-determined price, or even an estimate, on the cost of any procedures or packages offered at private hospitals as there are always optional and/or mandatory additional charges. This complicates the choice between private and public, as a direct price comparison cannot be made.

Perhaps the best example of this can be seen by comparing maternity packages. Given the nature of pregnancy and giving birth, many unexpected complications may arise during the process.

Maternity Packages

Although private hospitals have a list of maternity “packages” offered, they do not give an accurate estimate of the total fee of delivering a baby. Each maternity package at each hospital is different, although they generally include the following:

For the Mother:

  • Delivery suite charges, routine materials, dressing, and maternity nursery care
  • Assisted delivery instruments and foetal monitoring equipment
  • Entonox and basic medication
  • Breastfeeding instruction by International Board Certified Lactation Consultant
  • Breast-pump
  • Three standard meals a day

For the Baby:

  • Nursery and breastfeeding room
  • Routine nursing care and monitoring
  • Breast milk substitute, baby clothing, and napkins
  • Infant warmer and newborn resuscitation service
  • Transport incubator from Delivery Suite to Nursery
  • Baby bed warmer (on the first day)
  • Newborn vaccinations: Hepatitis B vaccine, and BCG
  • Vitamin K1 injection
  • Routine blood tests
  • Use of jaundice meter

Souvenirs

  • Digital photograph of newborn baby and a photo album
  • Baby gift

The following chart shows a comparison between the lowest possible costs for different maternity packages for a private (single bed room) in some of Hong Kong’s private hospitals.

Screen Shot 2016-02-12 at 12
**Non-booked: Cases or patients who have not undergone any antenatal checkup during pregnancy.

The figures above exclude many childbirth necessities, and therefore the prices of the maternity packages are well below the total cost to have a baby.

With so many additional fees (most of which are necessary), realistically, standard maternity package prices do not come close to the total cost of giving birth in Hong Kong. Since giving birth differs so drastically case-by-case, exact prices are hard to determine. However, a rough estimate of a maternity package + basic additional procedures is easily upwards of HK$100,000, without any complications.

In addition to childbirth, another example of the non-transparency of prices can be seen in the varying costs of surgeries and procedures.


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Surgeries

It is even more difficult to obtain a pre-determined price or estimate on a surgical procedure, unless you are in consultation with a specific doctor and/or surgeon. Even then, prices can vary drastically, dependent upon:

  • Room rate
    In addition to the actual room cost, the doctor/surgeon fee is dependent upon the room type and charge. The cost of the exact same procedure performed by the exact same surgeon will vary depending on the room type selected by the patient.
  • Time of procedure
    Certain hospitals will charge more for procedures performed at “auspicious” times; this applies even to emergency situations. Any time outside of office hours (Monday to Friday, 9am – 5pm) may cost more.
  • Surgeon experience
    The only place in the world with standardised surgeon’s fee is Malaysia. In Hong Kong, there is no set price for surgery. Dependent upon the surgeon’s experience, reputation and other various factors, the price associated with an individual surgeon’s expertise may fluctuate.
  • Additional complications
    Any unexpected complications will also increase the price of the procedure (any additional operations, medical equipment, extended room stays etc).

Problems occurring due to the non-transparency of hospital fees are not uncommon. On March 5, 2013, the South China Morning Post published an article detailing Bobbie-Ann Poulton’s hefty bill. For a standard 30-minute procedure (including suturing for eight stitches and other services), the bill came to be a total of HK$10,655. “They did not tell me the expected fee. If they had warned me of the price, I would definitely not have had it done”, Poulton said.

With prices so easily dropped and raised, it’s near impossible to get a reliable estimate from the hospital without consultation, even upon inquiry. The Hong Kong Sanatorium & Hospital, Matilda International Hospital, Canossa Hospital (Caritas), and Precious Blood Hospital all refused to give an estimate for an appendectomy (a standard procedure) as the price varied among doctors. According to a separate South China Morning Post article, “the price disparity between different doctors could come to as much as tens of thousands of dollars.”

The non-transparency of hospital prices makes it extremely difficult to compare costs between private and public healthcare services.


Health Insurance in Hong Kong

Those who opt for private healthcare should strongly consider health insurance, as the costs for an emergency situation or even pre-booked treatments are incredibly high.

There are a number of insurance companies in Hong Kong. Among the best known are AXA , Allianz , Zurich and William Russel . Each of these companies offers numerous programmes and plans, at varying prices and coverage.

All Hong Kong Health Insurance plans cover in-patient hospitalisation. Most insurance plans will cover any in-patient situations (although there may be sub-limits).

These programmes can be tailored to fit your needs, whatever they are. The higher the price of the premium (the fee that the customer pays), the higher the coverage received. However, by adjusting some categories that may seem unnecessary to you, costs can be lowered.

Below are a few optional categories that can drastically affect the price of the premium:

  • Out-Patient
    This includes clinics, specialists, and prescription drugs/medications. As an optional add-on, this may include sub-limits as well.
  • Cancer Coverage
    Since cancer is so prevalent and expensive to treat, insurance companies may cover oncological expenses depending on the coverage of the plan.
  • Area of Coverage
    The two most popular options are “Worldwide”, in which you can choose to receive treatment anywhere in the world, or “Worldwide excluding USA”, due to the extremely high cost of healthcare in the United States. Another less-expensive option includes “Asia Only”. If international insurance coverage is still too costly, there are a number local plans that are available as well.
  • Room Type
    Take note of the room type that insurance plans include. Depending on the price of the premium, some programmes have “private” as an option; however some plans may only cover up to “semi-private”, or lower.
  • Dental
    Some insurance plans do not include dental services, as this is not considered a medical “risk”. Certain insurance plans, however, will cover dental work up to a certain cost.
  • Maternity
    Due to the possible complications when having a baby, maternity coverage is extremely expensive. Maternity coverage is another optional choice for insurance plans. Most plans will include a “maternity waiting period” (usually 8 – 10 months). This means a woman cannot be pregnant within the first 8 – 10 months of joining a new insurance plan, she will not be covered for maternity costs.
  • Age
    As the age of the client increases, as does the insurance premiums (due to rising medical technology costs, more frequent health issues, and so on.) Each year, depending on your age, insurance premiums may go up.
  • Deductibles
    A deductible is the portion of the fee of each health-related expense that you will pay. The insurance plan will cover the remainder of the bill. The higher the deductible, the lower the premium. Deductibles can drastically reduce the over premium cost.

The decision between private healthcare and public services can be difficult to make. Since public standards are relatively high, private services (and health insurance) are certainly not a necessity in Hong Kong. After reading about the advantages of private healthcare, you can decide if such benefits are worth the extra cost.


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