Time to plug loophole on eyecare

Editorial | Mary Ma 11 Mar 2019

As the government reviews the Elderly Health Care Vouchers Scheme, it's clear enough for even the bespectacled to see the abuse by optometrists submitting inflated bills.

While the elderly should be encouraged to use the vouchers to seek necessary treatment in the private sector - including eye care that should form part of the primary health care system - the health authority has been surprisingly slow in spotting that abuse.

So, the officials shouldn't be criticized for considering a cap to limit an optometrist's claim per patient to no more than HK$1,000 every two years.

The optometrists are angry, threatening to take radical action to stress their points. In response, the government says it isn't discriminating against them, calling it just a move to fine-tune the scheme.

The anger voiced by the Hong Kong Society of Professional Optometrists was unconvincing. In the end, the scheme means big business for the profession.

Figures speak for themselves. The vouchers scheme incurred a total expense of HK$2.9 billion in 2018, doubling that in 2015. During the same period, claims by optometrists surged 19 times to HK$760 million - accounting for 27 percent of the scheme's total spending.

There are 697 optometrists under the program, meaning each claimed an average of more than HK$1 million last year. Wasn't that figure just too large to reach any other conclusion?

As the population ages, it's foreseeable that demand for health care services is bound to increase, putting immense pressure on the public health sector. In theory, a scheme like that of the vouchers would take some pressure off the public system by channeling minor cases to the private sector.

As far as eye care is concerned, an alternative remedy has to be found as officials put a cap on the amount of vouchers optometrists may claim.

Hong Kong may be advanced in many aspects, but its primary eye care services are rather backward. The issue is systemic.

People aren't educated to check their eyes regularly. Glaucoma, for example, is a common cause for partial vision loss or blindness among Asians. Regular checks of the eyes would pick up early symptoms frequently ignored by the patients.

By the time they feel worse enough to consult doctors for referral to the specialists, it's often too late to save the vision already lost. The optometrists can fill in the gap to flag early warnings to supplement the primary healthcare strategy.

It's common knowledge that early warning failure often leads to bigger medical bills for the public sector later.

Eye care is more than short or long-sightedness. It also involves health of the eye as a whole, like ocular pressure and health of the retina. While high ocular pressure causes glaucoma and vision loss, retina health can be monitored by special scans.

In Britain, these services are available at high street optical stores - some for free, and some for a small fee with no obligation on the part of customers to buy spectacles.

As SAR officials move to plug the voucher loophole, it's necessary to explore alternative ways to tap the private expertise.

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