ENG-2010 — Page 205

Health 159

In view of the shortcomings of the current voluntary private health insurance, the Government has proposed that government-regulated health insurance plans under the HPS should have the following key features:

• no turn-away of subscribers and guaranteed renewal for life

⚫ age-banded premiums subject to adjustment guidelines

• covering pre-existing medical conditions subject to waiting period

high-risk individuals insurable with a cap on premium loading

• risks arising from accepting high-risk groups to be shared out through High- Risk Pool industry reinsurance

no-claim discount for premiums

• insurance plans renewable on leaving employment and portable between insurers

• insurers required to report all costs, claims and expenses

• standardised health insurance policy terms and definitions

• establishment of a government-regulated health insurance claims arbitration mechanism

Another key feature of the HPS is to promote more transparent medical fees with packaged charging for common procedures. Private hospitals will be encouraged to offer all-inclusive and condition-specific packaged services and charging.

Under the HPS, service providers (i.e. insurance companies and private hospitals) will be subject to government regulation, so as to enhance price transparency, increase competitiveness of service provision and ensure adequate consumer protection. The HPS, when implemented, will require an expansion in the capacity of the private healthcare sector to cope with the potential increase in demand. This will have a positive impact on the long-term overall development of the healthcare industry. The Government will consider making use of the $50 billion fiscal reserve set aside to provide incentives to HPS subscribers.

The Government looks forward to full engagement with the community through. the second stage public consultation on healthcare reform. It will formulate the details of the scheme in the light of public views in order to lay a solid foundation for implementing the scheme and making further progress on healthcare reform.

Primary Healthcare and Medical Services

Primary healthcare covers a wide range of public health services such as health promotion and disease prevention. It is the first step in the healthcare process, comprising general outpatient services, specialised health care, and specialist medical treatment, provided for people in specific age groups who do not require hospital attention.