Hong Kong fee increases fail to solve healthcare financing crisis

[WORLD] Hong Kong's recent decision to raise public hospital fees has sparked a robust debate about the sustainability of the city's healthcare financing. While the government aims to alleviate financial pressures through these adjustments, experts argue that fee hikes alone are inadequate to resolve the underlying issues plaguing the system.​

Government's Rationale for Fee Adjustments

In March 2025, Health Secretary Professor Lo Chung-mau announced a comprehensive reform of the public healthcare subsidy system, set to take effect on January 1, 2026. Key changes include:​

Accident and Emergency (A&E) Services: Fees will increase from HK$180 to HK$400 per visit, with critically ill patients continuing to receive free treatment. ​

Specialist Outpatient Clinics: First attendance fees will rise from HK$135 to HK$250, and subsequent visits from HK$80 to HK$250.

Inpatient Services: Daily maintenance fees for acute beds will increase from HK$120 to HK$300.

The government projects that these fee adjustments will generate an additional HK$3 billion annually, which will be reinvested into the healthcare system to support patients and enhance services. ​

Expert Concerns Over Fee Increases

Despite the anticipated revenue boost, healthcare professionals and analysts question the effectiveness of fee hikes in addressing the systemic challenges of Hong Kong's healthcare financing. A 2023 research paper from the Legislative Council Secretariat highlighted that in 2019-20, over 50% of total healthcare spending was funded directly from government revenue, with household out-of-pocket payments covering most of the remainder. ​

The reliance on a predominantly tax-funded, single-payer system is becoming increasingly unsustainable, especially given the rapidly aging population and escalating healthcare costs. Experts argue that merely adjusting service charges without a fundamental reassessment of the financing structure will not ensure long-term sustainability. ​

Alternative Solutions for Sustainable Healthcare Financing

To create a more sustainable and dynamic healthcare ecosystem, experts propose several alternatives:​

Co-Payment Schemes: Implementing co-payment models where patients contribute a portion of their healthcare costs can help distribute the financial burden more equitably.

Mandatory Health Insurance: Introducing compulsory health insurance can diversify funding sources and reduce the strain on public finances.​

Private Sector Involvement: Encouraging greater participation from private healthcare providers can offer patients more choices and alleviate pressure on public hospitals.​

These approaches aim to balance resource allocation, enhance patient protection, and ensure that vulnerable populations receive adequate care without compromising the system's financial viability. ​

Public Response and Implications

The proposed fee increases have elicited mixed reactions from the public. While some understand the necessity of reforms to maintain service quality, others express concern about the affordability of healthcare, particularly for low-income individuals. The government's plan to expand medical waivers to cover more low-income residents aims to address these concerns, potentially increasing the number of beneficiaries from 300,000 to 1.4 million.

However, critics argue that without comprehensive structural reforms, fee adjustments and expanded waivers may only serve as temporary fixes rather than long-term solutions to the systemic issues at hand. ​

While the Hong Kong government's initiative to increase public hospital fees reflects an effort to address immediate financial strains, experts contend that such measures are insufficient to tackle the root causes of the healthcare financing crisis. A holistic approach, encompassing co-payment schemes, mandatory insurance, and enhanced private sector involvement, is essential to ensure the sustainability and efficiency of Hong Kong's healthcare system in the face of demographic and economic challenges.