The Hong Kong Healthcare System and my own experience

I have lived in Hong Kong for over three years now and my biggest complaint is not with the crowded streets, the tiny living conditions, or even the pollution but rather the Healthcare system. Never have I felt so uneasy about my own health being looked after than here in this mixed Healthcare system. Hong Kong has a mixed system consisting of both public and private hospitals, as well as clinics - a guide is provided below to help understand its makeup.

My personal experience with the system is as follows and I should mention that the fees listed are not averages or even typical as certain fees vary wildly from clinic to clinic and hospital to hospital and also depend on things such as location and notability/qualifications of the Doctor.

I go to a private Doctor's office where they will see me for a few minutes and charge me roughly $330 (HKD) for their time as well as a three days supply of medicine whether I require it or not. Antibiotics are also routinely provided at an alarming rate but this is common throughout Asia.

I have also gone to a private hospital for their out-patient services and for a specialist appointment. The charges for the out-patient and specialist were quite low at this hospital, around $200 for the visit each, but the medicine was generally more expensive than from the clinic taking my total bill to over $500.

On the occasion I saw the specialist at the private hospital I was given a satisfactory check by the doctor but was told I would need further tests done which would require staying in the hospital for a day to complete. I was told the cost would be roughly $30,000 (HKD) for this stay alone and not include anything beyond that to fix the problem. As I do not have insurance outside the public healthcare provided to every resident, I was advised I could go to a public hospital along with their referral letter.

Upon arriving at the public hospital with my referral letter I stood in line and handed in my letter to the desk to make an appointment. This comes to my main point of contention with the entire system. I went to make the appointment in July 2019 and my appointment has been set for March 2021, almost a year and a half in the future.

I am actually quite reasonable in accepting that there are very many patients in Hong Kong and that the system is stretched to accommodate them, however a wait of a year and a half just for tests (no treatment) should not be acceptable to anyone. I have spoken to local friends here and they have actually expressed surprise that my appointment is so soon! The idea that the worse off in society should receive significantly reduced healthcare services and in fact be expected to suffer because of their lack of economic standing bothers me to my core. I would be in favour of a mixed system if the basic public healthcare system provided to everyone was excellent and then a private system was available on top for elective surgeries and the like, but the current Hong Kong system is failing those in the lower tiers.

Maybe I take issue with this system so much because I am Canadian and have spent almost my whole life within the Canadian Healthcare system. That system also has waits for non-critical issues but for the vast majority of issues you are seen right away or within a reasonable time frame. Doctor's visits are also covered in Canada and would not cost you anything out of pocket. The tests which they would want me to spend $30,000 HKD on here would likely be done on the same day.

Let me end by saying something positive about the Public Hong Kong system told to me by friends - for serious issues and those that need immediate care, they say very positive things about their experiences at Public Hospitals and the quality of the services provided. The issues with wait times are hardly their fault and blame should not be put upon them for mismanagement of the entire system. I also have zero negativity towards the Doctors, Nurses, and other professionals that work in public facilities and I respect them and the care they provide.

BUT, the thought of waiting and suffering for years with ailments is not an acceptable system of care in a society. For those lower salary earners that can neither afford private insurance or the one-time fees at private Doctor's clinics, they must rely on outpatient services at public hospitals which means hours upon hours of waiting and then followed by months to years of waiting for further tests and treatment if they have been classified non-urgent.

Below are some more facts and links for you to read and educate yourself about the system further. Perhaps in the future I will discuss private insurance in Hong Kong.
  • "In 2016, Hong Kong had 1.9 registered doctors and 7.1 registered and enrolled nurses per 1000 population"
  • There are 12 private hospitals in Hong Kong including the following: Canossa Hospital (Caritas), Evangel Hospital, Gleneagles Hong Kong Hospital, Hong Kong Adventist Hospital - Stubbs Road, Hong Kong Adventist Hospital - Tsuen Wan, Hong Kong Baptist Hospital, Hong Kong Sanatorium & Hospital Limited, Matilda & War Memorial Hospital, Precious Blood Hospital (Caritas), St. Paul's Hospital, St. Teresa's Hospital, and Union Hospital.