A great change has come to America in
November. On November 6, 2008, Barack
OBAMA was elected US President. OBAMA, a
first-term Democrat, defeated his Republican rival, John McCAIN, with 52.5% and
46.2% votes respectively. The President
Election day attracted a voter turnout of 64%, a high level unseen for a
century. And, OBAMA was the first black
man elected US president. “It’s been a
long time coming, but tonight, because of what we did on this day; in this
election, at this defining moment, CHANGE has come to America,” said OBAMA in
his victory speech.
Ever since OBAMA announced his candidacy for
President of the US in February 2007, it had been addressed by the press and
the media that, “Something is happening.”
During the movements for the past 21 months, OBAMA’s platform rested
upon tremendous change in the United States and the establishment of a new path
for the American government. His
election campaign, his speeches and his weblog were all highlighted on change:
“It’s About Time… It’s About Change…” As
reported by the New York Times, he identified the issues of rapidly ending the
Iraq War, increasing energy independence and providing universal health care as
his top three priorities.
Doctors might be a bit more interested in
health care issue. On January 24, 2007,
OBAMA spoke about his position on health care at Families USA, a health care
advocacy group. He said, "The time
has come for universal health care in America…. I am absolutely determined that
by the end of the first term of the next president, we should have universal
health care in this country." OBAMA
cited cost as the reason why many Americans did not have health insurance. He proposed to provide affordable health care
for all Americans. This would be paid
for by insurance reform, cost reduction, removal of pharmaceutical patents, and
requiring employers to provide insurance coverage or to contribute to a new
public plan. For those not insured through
employment, he proposed a National Health Insurance Exchange that would include
both private insurance plans and a government-run option. Coverage would be guaranteed regardless of
health status, and premiums would not vary based on health status. Mandatory health care insurance for children
would also be provided.
In Hong Kong, we also face changes in the
medical environment. The first stage of
the public consultation on healthcare reform ended on June 13, 2008. Chapter one of the Healthcare Reform
Consultation Document entitled “Your Health Your Life” spelled out “The Need
for Change”. Correspondingly, the ending
of this chapter emphasized that “the time for reform is now….”
On June 13, 2008, Dr. York CHOW, Secretary
for Food and Health, said in the press release that: “The consultation showed
that the public generally supported the healthcare reform proposals, including
enhancing primary care, promoting public-private partnership, developing
electronic health record sharing, and strengthening existing public safety
net.” However, healthcare financing was
not mentioned, except that: "To the public, a major concern is what kind
of healthcare protection they can gain by contributing to a financing option." Regarding service reform, Dr Chow reported
that there were three areas drawing great public concern: “how to further
upgrade public healthcare service quality, resource management and
cost-effectiveness to ensure the public healthcare system can continue covering
the public's basic health needs, particularly the disadvantaged; how to ensure
fees paid by the public for private healthcare services and health insurance
are value for money, including upgrading the private sector's charging
mechanism's transparency and boosting service quality monitoring; and, how to
ensure both the software and hardware of the healthcare system can meet future
rising demand, including training of healthcare professionals.”
Another important document which talked about
changes was the Policy Address 2008-2009.
This was delivered by our Chief Executive on October, 15 2008. Unexpectedly, the focal point of discussion
was the introduction of a means test for candidates eligible for the raised Old
Age Allowance. The public reaction was
overwhelmingly negative. Around 60% of
respondents fought against the means-testing option. On October 24, 2008, a week after the
delivery of the Policy Address, our CE modified his original proposal by
shelving the idea. Again, as doctors, we
might be more interested in medical related issues of the Policy Address. It seemed that the focus was on “Healthcare
Reform”, which was one of the three titles under “Care for the People”.
“Healthcare Reform” covered four areas: “Consultation”, “Promoting the
Development of Private Healthcare”, “District Medical Facilities”, and
“Enhancing Primary Care Services”.
On October 16, 2008, a meeting was held by
the HKMA with Dr. the Hon. LEUNG Ka Lau to discuss the Policy Address. Much concern was expressed on how the
government was going to enhance primary care services. According to the Policy Address, a “Working
Group on Primary Care” would be set up “to introduce basic primary care service
models focusing on preventive care and a primary care register based on the
family-doctor concept.” A primary care
delivery model -the “community health centre”- would be explored “to coordinate
the efforts of different service units in the delivery of primary care
services.” Would these lead to further
expansion of services provided by the government against the private
market? Would these policies favor HMOs
and large group practices?
Are changes always necessary and good? Well, it’s about time; and it’s about
change……
(Source: HKMA News November 2008)
