Replies to LegCo questions

LCQ12: Medical fee waiver mechanism

Following is a question by the Hon Emily Lau and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (March 16):


Question:


A new charge for the Accident and Emergency service at public hospitals was introduced in November 2002 and the fees and charges for some public health care services were adjusted upwards in April 2003. In this connection, will the Executive Authorities inform this Council:


(a) of the annual numbers of access to public health care services by the members of families receiving Comprehensive Social Security Assistance (CSSA) since November 2002;


(b) of the annual numbers of applications for fee waivers made since November 2002 by users of public health care services who were not recipients of CSSA, and


(i) the number of such applications approved, broken down by whether the monthly household incomes of the applicants exceeded the median monthly domestic household incomes applicable to their household size and by the proportion of fees waived (full or half fee waivers), and


(ii) a breakdown of the rejected applications by the reasons of rejection; and


(c) whether they have publicised the medical fee waiver mechanism and taken the initiative to explain to patients and their relatives how to make applications?


Reply:


Madam President,


(a) Recipients of Comprehensive Social Security Assistance (CSSA) are being exempted from payment of public medical charges. From November 2002 to December 2004, there were 5,682,601 attendances that involved the use of public medical services by CSSA recipients. A yearly statistical breakdown is shown in Table 1.


(b) To assist vulnerable groups in the community other than CSSA recipients (i.e. low-income people, chronically-ill patients and elderly patients in economic hardship), the Government has formulated an enhanced medical fee waiver mechanism to relieve their financial burden. Depending on patients' actual needs, waivers may be granted on a one-off basis or valid for a number of months. This enhanced mechanism has been implemented since April 2003.

According to the enhanced fee waiver mechanism, non-CSSA recipients may apply for a fee waiver if they meet the following economic criteria.


(i) The patient's monthly household income does not exceed 75 per cent of the Median Monthly Domestic Household Income (MMDHI) applicable to his/her household size, and


(ii) the value of the patient's household asset is within a certain limit applicable to his/her household size.


A patient is generally entitled to a full waiver of medical fees if his/her monthly household income does not exceed 50 per cent of the MMDHI applicable to his/her household size and the asset limit criterion is met.


Aside from assessing the eligibility of an applicant based on his/her household income and asset, medical social workers also take into account various non-financial factors such as (i) the patient's clinical conditions; (ii) whether the patient is a person with a disability or a single parent with dependent children; (iii) whether a fee waiver can help solve the patient's family problems; and (iv) whether a patient has any special expenditure requirements that make it difficult for him/her to afford public medical fees.


There were a total of 132,141 fee waiver applications from non-CSSA recipients from November 2003 to December 2004. The numbers of full waivers and partial waivers granted are 122,554 and 8,811 respectively. A yearly statistical breakdown is shown in Table 2.


Information on the details of unsuccessful applications including the reasons for rejection are not readily available as such details are not captured by the Hospital Authority.


(c) To promote public awareness of the medical fee waiver mechanism, the Social Welfare Department (SWD) and the Hospital Authority have been displaying/distributing bilingual posters and leaflets at their frontline operational units, including public hospitals and clinics as well as SWD's medical social services units, family services centres and social security field units. Should there be enquiries on the operation of the waiver mechanism, non-CSSA recipients can approach the staff of relevant operational units and the duty officers will answer the enquires made in detail.



Ends/Wednesday, March 16, 2005

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