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Abstract Summary

The Hong Kong Special Administrative Government (hereafter HKSARG) proposed to launch a Voluntary Health Insurance Scheme (VHIS) in an attempt to incentivise the middle class to use more private health care services so as to lessen the burden on public health care services, in addition to implement more regulations on the hitherto more or less unregulated private health care industry and the insurance market. The proposed scheme has consulted the public and different involving parties for over six years and the minimum requirements previously set by the HKSARG has recently been amended. The main adjustments include the cancellation of the reserved 50 billion Hong Kong dollars in setting up the high-risk pool, the guarantee acceptance and portability from the original design.

The viability of the VHIS hinges mainly on whether it can attract the support of the working population in Hong Kong, especially those who have a stable income and can afford the premium. In designing this research project, employees and employers from several major industries in Hong Kong were chosen - the summation of their total GDP equivalents to 4% of Hong Kong total GDP. Their response to the upcoming VHIS is significant, as their decision on up taking of VHIS or not may affect those of the small and medium enterprises (SMEs) as well as those small firms’ employers and employees in Hong Kong.

Employers and employees’ representatives from major companies in Hong Kong were selected to be my interviewees. Face-to-face interviews with both employers and employees’ representatives were conducted and a total of 8 companies in different industries and one local university were selected. Most of the employers in the selected companies are not enthusiastic towards the upcoming VHIS for a number of reasons including insufficient manpower, high administrative costs, inadequate coverage, bad timing (they estimated that the proposed launching year [2019] would likely to be in a recession period) and lack of support from their staff. Similar findings from the employees’ representatives were obtained and the major reasons for their lack of interest in the VHIS include: that their existing GHI is already comprehensive enough, and they do not want to level down their existing coverage, their unwillingness to pay out-of-pocket to buy an extra plan or top up to the VHIS plan, that they are healthy enough and unneedy at the present moment etc. Besides, factors affecting their selected plan were asked and through such data analysing, we hope to collect more information on what are the obstacles that affect the major companies’ employers and employees on taking up the scheme. Afterall, this research findings contradict some previous local researches done which claimed that the VHIS has the support of most people in Hong Kong.

Abstract ID :
Submission Type
Authors (including presenting author) :
Ismail J (1)
Affiliation :
(1) Medical & Geriatrics, Pok Oi Hospital
Introduction :
Having consulted for years, Voluntary Health Insurance Scheme (hereafter VHIS) has been modified to its finalized version and going to be launched in 2019. This research was conducted throughout the consultation period and the purpose is mainly to examine the popularity of VHIS from the major suppliers and users in Hong Kong, thus, factors affecting these potential targets was collected through face-to-face interviews and findings in this study are different from what is known from the previous research studies (PwC, 2013; HKU POP SITE,2015, He, 2017).
Objectives :
To identify the key factors that may influence Hong Kong major companies’ employers and employees already with health benefits cover to take up VHIS compliant product or not, an insurance product proposed by the HKSARG, and their rationales of taking up or not. Three scenarios would be come across: which are factors influencing taking up, factors influencing rejecting taking up, and factors that depending on specific details in taking up.
Methodology :
Self-design guided questions, one for employer and one for employee were used and both English and Chinese version are available for the interviewees to select (Chinese is dominant in Hong Kong but some of the managerial grading or above are foreigners and English-speaking). The questions designed mainly focus their knowledge and interesting on VHIS and factors affecting their selection of their existing GHI or PHI and the upcoming VHIS. Each question in the self-design questions have an aim and action to bound the interviews dialogues. For instances, in the first question in employer’s version, by collecting the purchasing factors to see their interested on buying the upcoming VHIS compliant products or not. Qualitative inquiries involve asking the kinds of questions that focus on the why and how of human interactions and qualitative research questions need to articulate what a researcher wants to know about the intentions and perspectives of those involved in social interactions (Agee, 2009). The self-design guided questions were proof-read by professors before using in the interviews. Interviews were conducted by researcher alone and tape-recording and note taking was done during the interviews except one company refused audio-recording. All interviews were conducted in Chinese except one in English as the employer representative is English-speaking.
Result & Outcome :
Employers’ pre-disposing factors on not considering VHIS are due to high administrative costs, insufficient manpower and unwillingness to have extra payment, though 2 companies do not mind paying extra to increase the welfare of their employees. Endogenous factor is currently using a comprehensive GHI and do not want to level down the benefits of employees. Exogenous factor is imperfect timing, one of the interviewees predicting the year 2019 is in a recession period, inappropriate moment to launch VHIS. Scheme factors are no concrete framework, no linkage plan between VHIS and GHI plan, and entrance age restriction. A diagram is drawn showing the decision-making process of the employers in selecting VHIS and ended with all the parties invited remain unchanged after the scheme being launched. Employees’ pre-disposing factors is unwillingness to have extra payment, and endogenous factors are currently enjoying a comprehensive GHI plan and also healthy enough, do not need any self-purchased PHI, though only 2 have their own PHI. Exogenous factor is that they do not think there is added value or benefits in taking up VHIS. For scheme factors, majority said that the terms are unclear and disappointed by the shrinking terms. And for purchasing influencing factors, majority was upset by no sponsorship from the government and the tax-credit is useless or insufficient and hardly attract their purchasing desire. A diagram is drawn showing the decision-making process of the employees and majority would probably remain unchanged after the launching of VHIS.

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