Which Way Forward? An Analysis of Hong Kong’s Health System Reform Options

Hong Kong’s health system is remarkable for the fact that, in almost 170 years of existence, it has only been subject to change once when, in the early 1990s, a statutory Hospital Authority (HA) was created to manage public hospitals. Yet there have been consistent calls for reform over the years, with five consultation papers on reform options commissioned by the government since 1990. With reform momentum growing, this article provides a brief history of the government’s commissioned work culminating in the most recent recommendations. It then discusses the two areas for reform presently under consideration: financing reforms that include the development of health insurance; and a series of initiatives to improve existing structures, including integrating the health system, improving primary care, and creating electronic patient records. The discussion draws on examples from health systems such as Singapore’s and Japan’s to suggest that the various initiatives to improve existing structures provide a more appropriate pathway forward than the creation of insurance-based financing.