雙語社評齊齊聽

英語 (足本收聽)

普通話 (足本收聽)

【明報專訊】THE GOVERNMENT has unveiled its healthcare financing reform plan. There are voices in favour of it as well as against it. While it should persevere with the reform, the government must heed the doubts expressed. We must be clear about two facts. First, our healthcare system is fraught with problems. Public hospitals are overloaded. The situation will worsen as the population ages. Second, the private health insurance (PHI) system is full of loopholes now. Policyholders have difficulty making claims. Their interests are by no means effectively protected. This problem is serious. The government's scheme is not perfect. However, if it is in place, middle-class citizens will have wider PHI choice, and more public healthcare resources will be available for looking after elderly and infirm patients. It represents a step in the right direction.

英語

醫療融資方案公布之後，贊成和反對的聲音紛陳，政府在堅持改革的同時，必須細心聆聽各方的質疑；不過，我們必須認清兩個重要的基本事實：（1）現時的醫療系統存在不少問題，公立醫院超出負荷，情况將隨人口老化而惡化；（2）現行的醫療保險制度漏洞處處，「有供無賠」的問題非常嚴重，完全無法保障投保者權益。政府的新方案並不完美，但在醫保等方面為中產階層提供了較佳選擇，也讓中產騰出的公營醫療資源可以照顧較多的老弱傷病，這是正確的方向。

普通話

Public hospitals, whose services are inexpensive and very much in demand, now have a 90% market share. The system has long been overstretched. Not prepared to join the long queue, many have taken out PHI. They turn to private hospitals for healthcare services. However, there are many problems with PHI. According to the consultation document the government has just issued, the PHI market, which has been rapidly growing for years, is actually in a very sorry state.

英語

公立醫院收費廉宜，需求者眾，佔市場九成，系統早已不勝負荷；不少市民為免長期輪候，購買醫保並轉投私家醫院，但醫保問題多多。根據政府最新公布的醫療融資建議文件，這個生意年年急增的醫保市場，其實是千瘡百孔。

．個人醫保的利潤，原來遠較團體計劃為高，主要因素是個人醫保的申索率較低。2005至09年間，團體醫保的申索率（申索款額佔保費款額）為81%，但個人醫保的申索率只有57%；

．04/05至06/07這3個年度，私家醫院的住院收費中，病人須在保險賠償以外自掏腰包的比率，更由28.7%急升至41.6%。

普通話

*Individual PHI plans' profit margins are far higher than groups'. A factor in this is that individual policyholders' claim ratio is lower. During 2005 to 2009, the group claim ratio (the ratio of the amount of claims to that of premiums) was 81%, while the individual ratio was only 57%.

英語

*In 2004-05, inpatients paid out of their own pockets 28.7% of the total expenditure on private inpatient care. The ratio soared to 41.6% in 2006-07 (three years later).

英語

More and more people have taken out PHI. Medical costs have soared, but PHI claims have not gone up proportionately. One reason why the claim ratio is low is that some policyholders have refrained from making claims after their discharge for fear that they would be required to pay sky-high premiums. Another is that inpatients often find their policies do not cover the services they have received only upon their discharge.

英語

購買私人醫保的人年年增加，但醫療費用急升，索償的金額卻沒有相應增加。索償率低，一個原因是不少人買了醫保住院後也不敢索償，生怕保費從此變成天價；覆蓋率低的一個原因，就是病人在出院付款時，才發現原來保單並不包括相關的治療。

普通話

The government's healthcare financing reform plan is an important step in the right direction. The government will step up regulation. It will have insurers offer standard PHI plans, require private hospitals to increase their price transparency and take regulatory measures pertaining to insurers' and private hospitals' costs and profits. The introduction of such measures is worth looking forward to.

英語

政府提出的醫療改革，向監管醫保及私家醫院服務邁出正確而重要的一步；引入政府規管、推出標準條款的醫保、規定私家醫院收費要提高透明度、私院及醫保收費成本利潤要納入監管等措施，是值得期待的。

普通話

Hong Kong private health insurers must be aware that the days are numbered when they may keep raising premiums and refusing to meet claims. Private hospitals must be aware that, Hong Kong people being enlightened and very jealous of their rights, the days are numbered when patients would allow themselves to be fleeced. If they obstruct the reform, Hong Kong's healthcare system may collapse. In that event, the public, private hospitals and insurers will all suffer, and the government will have to intervene in the situation vigorously.

英語

香港的醫療保險業界必須認清，不斷大幅增加保費、有供無賠的日子，已經走到絕路；私家醫院也須認清，在民智已開民權上漲的香港，病人任由魚肉的日子應告一段落了。若業界拒絕改革，最終香港的醫療服務爆煲，只會形成市民、私家醫院、醫保從業員三敗俱傷的局面，最終引來公權力的強力介入。

普通話

明報社評2010.10.08

Presented by lecturers of Hong Kong Community College, PolyU and The Hong Kong Polytechnic University

Franco Wong, Lecturer, Hong Kong Community College

http://www.hkcc-polyu.edu.hk/index.php?lang=eng&cms=1394

袁振華博士，香港理工大學中文及雙語系講師

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