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 ups and downs. 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 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 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. Often times, 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)
Often times, patients with non-emergency needs will experience their appointments being rescheduled 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 and strain on the public healthcare system. Since wait times are long, so is the reality of overcrowded hospital rooms and healthcare facilities. Especially during the flu season, public hospitals have had occupancy rates of 130% across the city; the surplus of 30% patients having to resort to temporary beds laid out in corridors.
Customer Service & Comfort
Customer service and comfort as a patient are not a primary concern of Public Hospitals. Your physical and vital health are the priority. With a long patient list, you may feel that the healthcare staff are just going down the assembly line like robots. In many cases, it may seem that they lack compassion towards patients. Other complaints include communication problems and mediocre food for outpatients. Also, if follow-up procedures are required it is unlikely that the patient will get the same doctor for treatment. 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 your employer provided health plan (which in most cases are 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 can be out-of-pocket a lot of money, with the most common scenarios being:
your employer 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 be out of pocket $2,250 each day.
doctors 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 your basic doctors fees limits.
local plans generally do not cover chemotherapy, which can cost around $600,000 HKD. This amount would all be out-of-pocket
In order to mange this risk of being out-of-pocket, people can purchase a top-up medical plan. A top-up medical plan essentially means, an individual medical insurance plan with a deductible (amount that the policyholder must pay first, before the insurance kicks in). In this scenario, a deductible makes sense because the company group medical policy should be able to cover the deductible amount. The good thing about having a separate individual top-up plan is:
minimize the changes of you being 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 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.
good to get a top-up medical insurance plan now, when you are younger and healthier. If you have eventually accumulated certain major illnesses, you may not be able to obtain top-up medical insurance.
Private Medical Care
Private Healthcare is the solution to avoid long lineups 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 stands out for giving patients the ability to customize the services they receive and offers superior accommodations and customer service. Think: quick service for all needs, comfort, and privacy.
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. With the small size of Hong Kong, all private hospitals are reasonably
easy to visit.
PROS
Shorter Wait Times
Due to lower numbers of incoming patients, doctors in Private Hospitals have a more flexible schedule. This makes it very straight forward for seeing a doctor within a reasonable time frame.
Easily Accessible for Minor Health Concerns
Since there is less strain in Private Hospital, 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 major or minor health concerns.
Customized/Personalized Services
There are options! As a patient in the Private Healthcare system, you have the option of choosing your doctor, someone you feel comfortable with, and to consistently see the same doctor or physician. The flexibility of choice helps you feel comfortable with the care you are receiving.
Better Accommodations (private, semiprivate 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 helpful to note that both 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 set to open their fully owned CUHK Medical Centre in early 2020. 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 $800 and up, 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 with drastic price differences. Accommodations range from general wards (3-6 beds), semi-private rooms (2 beds) and private rooms (single bed).
However, deluxe suites are by far the most mind blowing in terms of costs and luxury. For example the Hong Kong Sanatorium Hospital and Matilda Hospital charge the highest for their deluxe accommodations:
HK Sanatorium Hospital: 37/F Ellen Suite - $23,000 ($2,930 USD) per night. It includes: a whole room for 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 Shangri-La hotel
Aside from the extremely luxurious suites and their hefty price tags, even basic private hospital rooms are normally more appealing than public hospitals. Patients should decide for themselves if the extra bonuses of private hospital stays are worthy of the higher costs. Expectant mothers in particular definitely have many different options to choose from in preparation of their maternity journey.
Varying Costs
Depending on the time of service, costs may vary. For example, there may be surcharges and higher expenses during holidays & weekends. We recommend visiting the individual private hospitals’ website for a detailed list of fee structures. One example to highlight is at 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. The same goes for in the case of 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 going Private?
Everyone's healthcare choice is a very personal decision. There is nothing wrong with the Public Hospitals in Hong Kong; the care takers will ensure your 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 staff to meet the demand of quality patients expect for investing their money into private healthcare services. It is also valuable to note that many of the private doctors are also working in the public system, which allows them to remain relevant in working with advancing technologies.
Personalized Care
Excellent customer care
To reiterate, Private Health Care thrives in providing the best service offerings for their patients. Customers receive what they pay for and that is the luxury at a cost. Not completely necessary, this offering of personalized care can be considered a priority very much for some individuals. It is always best to be aware of these 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. Personal doctors will get to know their patient’s habits and daily lives. Such doctors may also be aware of life changes (death in family, divorce, relocation etc.) that could be valuable and useful information when treating patients. More importantly, having a consistent doctor to go to long term allows for better, customized treatment. The doctor will be familiar with the patient’s conditions and needs. For example, your medication and prescription history and medical diagnostic test information will be filed with the same medical team and 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 helps you feel comfortable. 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 a million choices and plans! Don't worry, we are here to accommodate your insurance needs. The most efficient way to learn more about your insurance options, and the best suited for you, is to seek a certified insurance broker. Contact our Groveland team today: info@groveland.com.hk
