Health Insurance Reform in Hong Kong in an Era of Change

Healthcare has been put at the top of the agenda and a primary political, economic and social issue in many countries. It has been a focus of international concern especially in the post-1975 era when welfare states worldwide entered into the era of retrenchment. In the aspect of healthcare, governments have been facing a dilemma over healthcare financing: how to improve the health status of the population and deliver better medical services while containing the growth in healthcare spending caused by ageing population, higher user expectations, and rising medical costs.

With the financial sustainability of the healthcare system being questioned, the Hong Kong government has been releasing a number of public consultation documents on healthcare financing reform and a discussion paper: Towards Better Health (1993), Improving Hong Kong's Health Care System: Why and For Whom? (1999), The Lifelong Investment in Health (2000), Building a Healthy Tomorrow (discussion paper) (2005), Your Health, Your Life (2008), and My Health, My Choice (2010). However, none of the financing options proposed before 2008 has gained majority support. The consultation exercise on the option of voluntary health insurance proposed in 2010 ended in January 2011 and the government is collating and analyzing the views gathered from consultation. This study will use the theory of historical institutionalism to examine how institutions, together with multiple internal and external factors or being taken place inside particular political, economic, social and cultural contexts in Hong Kong structure interactions that generate distinctive national trajectory of healthcare financing policy over time. It will also examine how the case study of Hong Kong contributes to the theory of historical institutionalism and welfare regimes. 

Full paper download: 2.3.1 Sabrina Ching Yuen Luk.pdf