How to Choose Between Public & Private Healthcare

Hong Kong offers Public & Private healthcare, but how do you decide what is best for you? Both options have its positives and negatives. We're here to help you with an outline of the basics:

Public Healthcare

Hong Kong’s Public Healthcare (offered by the government) is more common, affordable and easily accessible. All run by one organization, the Hong Kong Hospital Authority (HA) manages 42 public hospitals and 120 outpatient (specialist & general) clinics. As part of its public service, the Hong Kong government subsidizes healthcare for eligible individuals who:

have an HK Identification Card
are children under 11 with residence status
are approved by the Hospital Authority

Those who do not fit the three eligibility criteria are considered non-eligible persons; however, non-eligible persons can still receive health care at a higher, non-subsidized cost (i.e. tourists visiting Hong Kong).

PROS

Many Locations

Since the HK HA has an extensive network of healthcare facilities, it is not difficult to find a convenient location, close to home that is suitable for your treatment needs.

Affordable

For eligible persons with an HKID, it costs $120 per night to stay in a general bed at the public hospital. These subsidized costs range per attendance. Other examples include: $50 for General Outpatient visit, $135 for Specialist Outpatient, or $180 for Accident & Emergency.

Quick Treatment for Accidents & Emergencies

The public system prioritizes emergency care over anything else, and the facilities are equipped for and focused on such emergencies. This is a major consideration, as patients with non-urgent cases end up on a long wait-list.

Patients go through a triage system where they are organized into 5 categories when they visit the Accident & Emergency services at a public hospital. Below are examples of estimated wait times, which vary depending on the current demand:

Critical (Triage Category 1): Immediate treatment
Emergency (Triage Category 2): 95% of patients in this category will be treated within 15 minutes
Urgent (Triage Category 3): 90% of patients in this category will be treated within 30 minutes
Semi-urgent: 2-8 weeks
Non-urgent

Teaching Hospitals

A select number of hospitals are also used as teaching hospitals; these hospitals promote the exchange of academic knowledge and experiences while engaging in the latest technologies and conducting of large-scale research projects. The early adoption of the latest technologies and treatments has given teaching hospitals a competitive edge against non-teaching hospitals. Oftentimes, rare cases are best treated at these hospitals due to their enhanced research knowledge. Queen Mary Hospital and Prince of Wales Hospital are listed as official public teaching hospitals in Hong Kong.

CONS

Long Wait Times (non-urgent cases)

Oftentimes, patients with non-emergency needs will experience frequent appointment rescheduling, leading to delays for weeks, months, or even years depending on the service or procedure. For example, urgent cases may be treated within 1 week, but stable cases may wait up to 100 weeks, or more!

Overcrowded

With the ageing population of Hong Kong, there is a high demand for healthcare, putting strain on the Public system. In an attempt to provide healthcare to as many people as possible, hospital rooms are often overcrowded and healthcare facilities overloaded. For example, during the flu season, public hospitals have had occupancy rates of 130% across the city; the surplus 30% of patients having to resort to temporary beds laid out in corridors.

Customer Service & Comfort

Customer service and your comfort as a patient are not a primary concern for Public Hospitals. Your physical and vital health are the priority. As a result of long patient lists, you may feel that the healthcare staff act like robots, working with emotionless efficiency. In many cases, it may seem that they lack compassion towards patients. Other common complaints include communication problems and mediocre food for outpatients. Further, if follow-up procedures are required it is unlikely that the patient will get the same doctor for treatment which means the new doctor may not be as familiar with you and your case. In summary, in order for Public Hospitals to run at maximum efficiency, patients are left with minimum personal service.

Does Not Cover Dental Health Care

Unless a patient’s case is an emergency dental situation, all other dental care services are not covered by the Hong Kong Government. Public Health Care only covers pain relief and extraction treatments at a public clinic. This is when an employer’s health plan or your own health insurance comes in handy for covering your dental health needs (e.g. regular check-ups and cavity fillings etc).

Visit the Hong Kong Hospital Authority website for more detailed information on any specific subject related to public healthcare: http://www.ha.org.hk/visitor/ha_index.asp.

Employer's Plans & Benefits

In most professions, employees will be provided with their employer's medical insurance plan. These plans cover a range of health and medical needs. Depending on the health plan provided by your employer (which in most cases is minimal), you may consider obtaining your own supplementary/individual medical insurance coverage.

Because many employer plans are basic, there may be many cases where you will have to pay a significant amount of money out-of-pocket, with the most common scenarios being:

Your employer's plan has Ward level coverage, with a room & board sub-limit of $750 HKD. If you choose a private room, which costs $3,000 HKD, you will have to pay $2,250 per day out of pocket.
Doctor and anesthesiologist costs are capped depending on the level of surgery. However, doctors are afforded the flexibility to charge what they want. In many cases, they are well in excess of basic doctor's fees limits.
Local plans generally do not cover chemotherapy, which can cost around $600,000 HKD. This amount would have to be paid entirely out-of-pocket.

In order to manage this risk of out-of-pocket expenses, some people opt to purchase a top-up medical plan. A top-up medical plan is essentially an individual medical insurance plan with a deductible (threshold amount the policyholder must pay before the insurance policy is triggered). In this scenario, a deductible makes sense because the company group medical policy should be able to cover the deductible amount. The benefits about having a separate, individual top-up plan is:

Minimize the chances of you paying out-of-pocket in the above mentioned scenarios
Although the top-up plan is deemed as a secondary policy (you can claim the company group medical first), when you are between jobs, laid off, or into retirement, your top-up plan can act as your primary policy
Most top-up medical insurance plans are guaranteed to be renewable - this means that once your application has been approved, they must renew your policy each year, as long as you pay the premiums. So even if you develop a major illness during the policy term (that was not a pre-existing condition), you will be covered for that major illness for the rest of your life, as long as you keep paying the standard age premiums.
It is advisable to get a top-up medical insurance plan sooner rather than later, if you have eventually develop certain major illnesses, you may not be able to successfully apply for top-up medical insurance policies.

Private Medical Care

Private Healthcare is the solution to avoid long queues and overcrowded Public hospitals. Private healthcare may not be a necessity for all patients, and at times can be viewed as a luxury. Choosing to go Private allows patients the ability to customize the services they receive and offers superior accommodations and customer service. Excellent and prompt service for every need, a comfortable stay and a private space are what sets Private Healthcare apart.

Currently, there are 12 registered private hospitals under the Hong Kong Private Hospitals Association: 6 on Hong Kong Island, 4 in Kowloon, and 2 in New Territories. Given the small geographical size of Hong Kong, all private hospitals are reasonably accessible to patients.

PROS

Shorter Wait Times

Due to a lower number of incoming patients, Private Hospitals are able to better accommodate the demand. This means all patients are able to see a doctor within a reasonable time frame.

Easily Accessible for Minor Health Concerns

Since there is less strain on resources in Private Hospitals, seeing a doctor for non-emergency and minor health concerns is more readily available. Patients have an easier access to contacting their personal doctor for regular check-ups and other health concerns whether it be major or minor.

Customized/Personalized Services

There are options! As a patient in the Private Healthcare system, you have the option of choosing a doctor you are comfortable with and to consistently see that same doctor or physician. The ability to choose ensures that you feel you are getting the most suitable care for your needs.

Better Accommodations (Private/Semi-private rooms)

Private hospitals hold high standards for patient comfort and overall experience. A stay at a private hospital can be very comfortable, or even luxurious in Hong Kong. Private hospitals provide services that may seem like a hotel, especially in a private room or suite. These comforts and luxuries are offered to patients at a cost. With proper planning and choice of health insurance coverage, you will benefit in receiving ideal coverage to subsidize the cost of Private Health Care.

Teaching Hospitals

It is important to note that the private hospitals, Gleneagles Hospital and Hong Kong Sanatorium Hospital, are listed as official teaching hospitals for the Li Ka Shing Faculty of Medicine at HKU. Additionally, the Chinese University of Hong Kong is has opened their fully owned CUHK Medical Centre in early 2021. The non-profit and private teaching hospital will manage 516 inpatient ward beds and has pledged to reserve 70% of its inpatient beds with affordable prices specifically for Hong Kong permanent residents.

CONS

Higher Costs

Costs in Private Hospitals are significantly higher due to the personalized service and more comfortable accommodations. This is why health insurance is strongly recommended to help cover the high costs. For example, a night at HK Adventist Health – Tsuen Wan costs at least $800, compared to the $120 per night at a Public Hospital. (However, they do have a low-charge rate of $120 for those who meet requirements, like getting a referral from the HK HA). The range of rooms offered at private hospitals also come at varying price points. Accommodations range from general wards (3-6 beds), semi-private rooms (2 beds) and private rooms (single bed).

For the most comfortable, private and luxurious experience, deluxe suites are an option for those seeking to spare no expense. For example, these are the rates the Hong Kong Sanatorium & Hospital and Matilda Hospital charge for their deluxe accommodations:

Hong Kong Sanatorium & Hospital: 37/F Ellen Suite - $23,000 ($2,930 USD) per night. It includes: a whole room for the patient with its own private lavatory and washroom, spacious sitting area with a 70-inch HDTV (additional, smaller models available in the patient's and companion rooms), an 8-person dining area, open kitchen, refrigerator and microwave oven, a companion room with private lavatory and washroom, and a lavatory for visitors.

Matilda Hospital: “VIP Room” - $5,000 (637 USD) per night It includes: Spacious room decorated with hotel suite aesthetics, private balcony, and catering from the Shangri-La hotel.

Aside from the extremely luxurious suites and their hefty price tags, basic private hospital rooms are typically more appealing than public hospitals. Patients should decide for themselves if the extra comforts and conveniences of private hospital stays are worth the higher costs. Expectant mothers in particular have many different options to choose from in preparation for their maternity journey.

Varying Costs

Depending on the time the service is provided, costs may vary. For example, there may be surcharges and higher expenses during holidays & weekends. We recommend visiting the individual private hospital’s website for a detailed list of fee structures. For example, at the Hong Kong Sanatorium & Hospital: Outpatient consultations made on Mondays-Fridays from 9am to 7pm are charged $320, while on Sundays and public holidays outpatients are charged $400 the entire day (8am – midnight). All other times (week days after 7pm & Saturdays) are also charged $400.

Emergency Situations Transferred to Public Hospitals

Although (some) Private Hospitals do operate 24-hour outpatient clinics, Private Hospitals may not be fully equipped to treat medical emergencies and will likely send these urgent cases to a Public Accident & Emergency department. This is also the case for a maternity or pregnancy accident; if there is a dire emergency at a Private Hospital, the mother and baby are sent to a Public Hospital for the appropriate emergency care.

Why pay the cost of Private Healthcare?

Everyone's healthcare choice is a very personal decision. There is nothing wrong with the Public Hospitals in Hong Kong; the care takers there will help ensure you regain health and well-being. Even though Private Healthcare costs are more expensive, many locals and expats choose to go Private over Public Healthcare. But, why? And what are some other considerations?

Higher standard of healthcare
- Private hospitals are equipped with the most experienced and competent staff to meet the quality patients expect for investing their money into private healthcare services.
Personalized Care
- To reiterate, Private Healthcare thrives in providing the best service offerings for their patients. Customers receive what they pay for and that is the luxury at a cost. Although not completely necessary, this offering of personalized care is very much a priority for some individuals. It is always best to be aware of the options available to any individual living in Hong Kong.
- Patients have more control over the services they pay for: scheduling appointments, room accommodations, choice of doctor.
Greater Knowledge of Medical History
- Choosing your own doctor means that he/she has the opportunity to get to know you over the course of your healthcare journey. Personal doctors will get to know their patient’s tendencies and daily habits. Such doctors may also be made aware of life changes (death in family, divorce, relocation etc.) that could be valuable and useful information when treating patients. More importantly, having the same doctor allows for consistent treatment, better suited to an individual. The doctor will be familiar with the patient’s conditions, medical history and preferences. For example, your medication and prescription history and medical diagnostic test information will be filed with the same medical team and made known to your doctor.
No Language Barrier
- Although English is an official language in Hong Kong, not all public healthcare workers speak English with the level of fluency that makes you feel comfortable and gives you peace of mind. Private healthcare allows expats to be reassured that the doctors and staff they choose can communicate and answer your concerns in a way that you're comfortable. In addition, it is common for private hospitals to specifically hire doctors from around the globe in order to properly cater towards individuals of various cultural backgrounds.

Find the Entire List of Hong Kong's Private Hospitals Here:

http://www.privatehospitals.org.hk/en/hospitals.htm

See how others rank Hong Kong’s Hospitals based on overall services here

How do I purchase private health insurance?

There are seemingly endless choices and hundreds of plans available for purchase, it can be overwhelming! Don't worry, we are here to accommodate your insurance needs. The most efficient way to learn more about your insurance options, and the ones best suited for you, is to seek a certified insurance broker. Contact our Groveland team today: info@groveland.com.hk