'Three highs' fight plan for middle-aged people

A middle-age health voucher should be introduced for chronic disease screenings to facilitate early detection of the "three highs" of blood pressure, sugar and fat, a think tank has proposed.

In its latest report on the health-financing system, Our Hong Kong Foundation suggested launching a pilot "chronic disease screening voucher and management scheme" to offer full subsidies for residents aged between 45 and 54 to undergo checks for the "three highs" that could lead to chronic illnesses such as diabetes and cardiovascular disease.

Once they have taken part in screenings, they will be entitled to medical care for life, said the think tank, chaired by Hong Kong's first leader Tung Chee-hwa.

The foundation said that in 2019, 78.1 percent of the population above 65 suffered from at least one chronic illness.

By partnering with private institutions in taking care of these patients, authorities can alleviate the heavy burden on public hospitals and clinics and reshape the city's medical system into one focusing on primary health care by encouraging residents to pursue early screening, diagnosis and treatment.

Although public-private partnerships have existed for years - in which authorities pay for people's medical services at private institutions while only charging them fees equivalent to public ones - the current partnerships only cover limited services and lack coordination.

That has created much pressure on the already overloaded public medical system, as people still flock to public hospitals due to tight budgets, despite 70 percent of primary medical services being provided by the private sector.

On the pilot scheme, the foundation conducted a survey and found 75 percent of nonchronically-ill respondents are willing to take part in it.

Although authorities will have to forfeit expenses for the health vouchers for screenings, the foundation's financial analysts believe it can save 47,000 lives and HK$12.5 billion public medical spending in 30 years, just by launching the scheme for high blood sugar screenings.

Patients diagnosed with "three highs" should be entitled to personalized disease management according to risk categories.

The annual medical expense for a person diagnosed with diabetes but do not suffer from derived conditions range between HK$5,950 and HK$15,383, with the band rising as patients age, the think tank said. It added authorities should mull if extra subsidies should be given to low-income groups so they can be taken care of by the private sector.

For a diabetic patient staying at hospitals for complications, the annual medical expense is HK$123,364 and the foundation suggested referring these cases to public hospitals.

The foundation also suggested authorities purchase consultation services from family doctors to design lifestyle changes for those who are at risk of developing "three-highs" and arrange follow-up screenings for them.

It estimated offering subsidies of HK$350 for each person, so they can do follow-up consultations at private family doctors of their choice.

But the foundation said authorities should "strategically purchase" private services, after looking into service providers' networks. Clear instructions should also be given on their responsibilities.

The foundation's head of health care and social development research, Pamela Tin, said: "Authorities must continue to strengthen the construction of Hong Kong's primary health-care ecology, especially in developing public primary health-care services.

"At the same time, they should consider how the private sector can provide affordable services to cater to long-term demands of patients, and to help citizens manage their health condition."

jane.cheung@singtaonewscorp.com