Essay: Development of sustainable health-care system

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CHAPTER 1 INTRODUCTION
Background
Health systems around the world are facing increasing challenges: this is how to improve the medical services accessibility, improving quality and controlling health care costs and expenses. Required by the public and policy makers is good value for money, there are coordination and attach great importance to health and disease prevention medical services, as well as to shorten the waiting time and easier access to information. Local governments are exploring or implementing various medical services and reform of the financing system, brought about by the ever-changing needs of the community. The health care system of Hong Kong internationally. Because of Hong Kong\’s vital statistics and the best medical professionalism (including low infant mortality, high life expectancy, medical staff trained and professional level, members of the public can enjoy inexpensive public health care service, etc), its health care system has a leading position in the international arena. As in many other places, Hong Kong\’s health care system is fragmented and not patient-centered, not focused on the integration of primary and second-tier medical. The system faces the following challenges:
(i) The incidence of certain diseases is on the rise – although life expectancy rate and infant mortality have outstanding performance, the incidence of common diseases (such as diabetes and different types of cancer – the number one killer in Hong Kong) have continued to rise, heavier medical burdens. Long waiting time for medical treatment, modern life\’s pressures, lack of preventive care and primary health care services, make this tendency worse.
(ii) Limited ability to cope with demographic changes and shortcomings – the birth rate low, workforce reduction and the increased ratio of retired elderly people, leading to demographic shifts, need to deal with different age within the elderly population brought different medical needs. Due to the shrinking of the labour force, the dependency ratio increased, existing health-care system in responding to these new demands, capacity is limited and insufficient.
(iii) Insufficient development of the preventive services – Hong Kong\’s health care system has been criticized for cellular systems, public and private primary and secondary medical services workload imbalance and lack of coordination. While over-reliance on treatment of patients with disease, does not pay attention to their own health and prevention.
(iv) Relying too much on treating low – the public health awareness, tendency to seek a swift way to cure diseases, lead us to believe that the public should increase on individual health responsibility and strengthen health awareness and adopt appropriate healthy lifestyle.
(v) Continue to improve the quality of health care – this challenge clearly shows that the government must improve the quality of health care on the different areas, including increased efficiency, increase the health care system\’s response capacity, accelerate the adoption of innovative treatment methods and prevention measures, use of medical resources, enhance management and performance of the system. These are the focus of future development.
Published by the health care reform proposals in the past, reflects the reaction the government need to develop a strong and sustainable health-care system. But the medical services of public interest, medical resources, just like our environment, to avoid misuse and abuse cases, so that the concept of sustainable development, but are being ignored. Society rarely focused on encouraging individuals responsible for their health, and behavior patterns to improve the public health, and to encourage the best use of resources. The government do not focus on health service providers and the Government, for their efforts to build a high quality, efficient, providing the public with an accessible, efficient and effective health care system.
Aim
Development of sustainable health-care system is a clear goal, but how to lead the continued development of Hong Kong\’s health care system and financing are not clear. While financing is an important part of an excellent health care system, necessary conditions, other factors include social values, behavioral patterns, clear health care objectives and targets is also important. The government also need to introduce a comprehensive institutional arrangements and incentive systems, in order to facilitate service delivery and encourage the right behaviors. If the government do not pay attention to these factors, rush off to put more money into health care system, may lead to greater consequences. Sustainable concepts is not just about financial issues, values and behavior change and effective institutional arrangements. The purpose of this study is to propose a way forward for Hong Kong, strengthening our health care system, responsiveness and sustainability, which will continue to protect and improve the public health, to meet the needs and expectations of patients and prepare for rising medical costs in the future.
Objective
Any health care reform proposal should be patient-centric, consider financing or funds cannot, and must focus on the overall health of the community. The development of Hong Kong in the future must work towards the following goals:
(i) To emphasize prevention and to share ways so that people have better health and quality of life;
(ii) Strengthening patient-focused and quality health care services, especially to the elderly and chronically ill patients;
(iii) By changing the behavior of individuals, Governments and providers to ensure the sustainability and effectiveness of the health care system.
To achieve these objectives, the research will be based on the following core values as a basis for recommendations:
(i) Equity and accessibility – with tax-based financing system should continue to be a fair and risk-sharing mechanisms, provide a safety net for the people of Hong Kong. New medical financing system should strengthen intergenerational fairness should also expand primary health care service and introduction of evidence for new drugs and technologies, improve the accessibility of medical services to the public.
(ii) Caring and sharing with each other-we should change users, providers and Government action, and stressed the shared goal of strengthening mutual care. Meanwhile, more public participation in improving health and strengthening the function.
(iii) Efficiency – medical resources are valuable to the community, the medical system should be to facilitate and promote early preventive work, reducing patients \’ medical needs. and through effective management and co-ordination, appropriate use of new technologies and better public-private cooperation, reduce the waste of resources.
(iv) Quality – should pay attention to the quality of medical care continued to improve, and through our accreditation standards, all-round service concepts and use by a registered or accredited providers of services and to achieve its objectives.
(v) Select – more transparency in health care systems to provide users with more choices while fostering personal responsibility for their health, attention to public-private collaboration to develop systematic means of cooperation, so that the public has more choice.
Introduction
Reform of the health care system must be to improve system performance, and providing incentives to strengthen and safeguard the people\’s health center. Reforms should include governance, management, providing services and financing of the change, in order to achieve those objectives. Though all retain their social, economic and political characteristics of world health care system governance, management and service delivery arrangements in a similar direction. Therefore, different economies have different health care financing mechanisms, which has four main financing: (a) In tax-oriented model, (b) social health insurance model, (c) Voluntary private medical insurance model and (iv) Medical savings model. Each financing methods are not mutually exclusive, the following analysis features and advantages and disadvantages of each mode.
In tax-oriented model
Use general tax revenues to pay for medical services, often rely heavily on the income tax, corporate tax and indirect taxes; and the private medical services by users or by private insurance. Health care system tax-dependent countries or regions including the United Kingdom, and Sweden and Hong Kong (mainly public hospital services). In these systems, the Government will provide a grant to a health or hospital authority and then by the regulatory body for funding of public hospitals. Patients using public medical services, can be heavily subsidized. This tax-based medical model has the following advantages: low administrative costs and everyone can equally enjoy public-funded services. While its weaknesses include: the size of the Government vulnerable to influence economic performance; other services have to compete for resources from the total taxes; taxes extremely difficult for rising medical needs; consider public services often are not consumer-oriented and based on the tax system is basically a “pay as you” system. Such a system cannot solve the population ageing and intergenerational equity issues – reduced in proportion as younger taxpayers, will lead to increased taxes on the next generation of taxpayers, to cover the medical needs of the elderly.
Social health insurance model
Social insurance schemes are compulsory contributory scheme. Under these plans, every working person (usually in conjunction with employers) have to contribute to a health insurance fund. This fund managed by ad hoc independent bodies, the Government is to maintain a certain degree of distance. Social security schemes Community contribution rate that the premiums are not linked to personal health, so as to make universal coverage. Public and private sector service providers will be available to all of the services provided by the social security fund. Mainly relying on social security to pay for medical services in the form of country or region, including Japan, and Taiwan, South Korea, Germany and Canada. Netherlands and Switzerland have also adopted the social insurance model, by private insurance institutions. The advantages of social security model are: the income and expenditure of the Fund has a higher degree of financial transparency; when there is a need to increase premiums and an increased tax rate easy because this system is “money follows the patient” than tax-oriented on service model can better meet consumer needs. But this also has its disadvantages: collect premiums and pay accounts for higher administrative costs; incentives based on system, poor management can lead to unnecessary abuse of service; and “tax-oriented” model, the social security system is “PAYG pay” system cannot solve the problem of population ageing and intergenerational equity.
Voluntary private medical insurance model
Different from the system of social security, private health insurance is usually an individual or groups (mainly employers) voluntary purchase. Premiums shall protect the project and determine the State of health of the insured (known as the “empirical contribution rate” (experience rating). Therefore, the elderly and people with medical records have to pay very expensive premiums. United States is the only industrial nation to rely on private insurance to pay for medical services, most working adults get medical insurance through their employer. United States Government there are two tax revenue insurance plan (health care programs – Medicare and Medicaid programs – Medicaid) to cover medical expenses for elderly and low-income people. Private health insurance has also played an important role in some countries, such as Australia. Australia has compulsory national insurance system, private insurance is regulated by the Government and voluntary participation. All insurance plans are subject to the rate of Community contribution. Australian Government provides financial incentives to encourage citizens to buy private medical insurance plans that are registered. Policyholders may get 30% from the State compulsory health insurance contributions tax rebates. Buying private insurance benefits include: you can choose a private doctor, choose a private hospital and for non-emergency treatment of diseases with a more flexible schedule. Benefits include private medical insurance system: protection scheme and service provider to the user greater choice to purchase sufficient protection for products and services more consumer-centric. Its disadvantages include: high administrative costs if mismanagement have abuse; the unemployed, the elderly and those with chronic diseases are difficult to obtain protection.
Medical savings model
Different from insurance (insurance is limited per year, all participants contribute to a fund used to fund all costs of the year), medical savings patterns are stored in personal contributions account can be accumulated for a long time. Based on a risk-sharing perspective, the medical savings account is another method of financial risk-sharing. Without risks to all participants a year, with accumulated funds to take risks. Health savings account contributions are usually mandatory. The medical savings accounts are attempting to address population ageing and intergenerational equity measures: each person for their own medical needs upon retirement and savings rather than increase the burden of the next generation. Singapore was the first country to use this system, and a medical savings scheme in the country and the United States appeared. Benefits include medical savings mode: the community more receptive (contributions not black holes buried in premiums or taxes, and remain in the accounts of the participants). This is the only effective method of addressing the issue of intergenerational equity; to increase user capacity, and can cause changes in consumer behavior; and the insurance system and tax payment system, users will be more prudent use of their savings account balances. Savings plans of shortcomings is including lack on disaster sex disease of risk share of function, especially in participation plans of early, account underfunded of Shi, if Government and not for participate in who bear healing dangerous disease of risk, and no purchase dangerous disease insurance, problem will more obviously; another shortcomings is participate in who to bear high of administrative fee (including levy, and paid and fund management, costs). Therefore, no country will rely on savings as the sole method of financing medical financing.
This paper will explore the feasibility of health care financing in all aspects in the following sections:
Chapter 2 Literature Review will gives a review of the research done.
Chapter 3 Research Methodology will describes the methodology and methods and the rationale for their use.
Chapter 4 Research finding will provide an analysis of the data collected will be done and;
Chapter 5 the conclusions and recommendations will be presented.
CHAPTER 2 LITERATURE REVIEW
The introduction and comparison of chapters in different parts of the health care financing policy.
Australia
On health care financing, the different Federal Government have different positions on universal health insurance plan, particularly in the 70 \’s and 80 \’s. In 1975 the Labour Government introduced public-funded, called “health plans” the universal health insurance plan. However, the Liberal party coalition Government in 1981, “health plans” downsizing into a voluntary scheme. Subsequently, the Labour Government in 1984, the establishment of a funded tax nationwide medical insurance system, namely “health care plan”. Up to now, the system has not changed much. In short, the “health care plan” provides Australians with free hospital treatment, And primary health care services and prescription drugs provides financial assistance to Australians. (Hilless and Healy (2001)) Australia since 1984 has been for health care reform to control costs and improve efficiency, and promote private sector participation in the provision of medical services and financing. For example, under the 1998 private health insurance incentives Act, the Federal Government offers premium 30% tax refund to the insured in order to encourage people to buy private health insurance. (Hilless and Healy (2001)) Australia\’s health care financing system is to tax-based financing system, health care is mainly funded from general government expenditure. Federal, State and territory governments, consumers and the private sector are to a certain extent to finance health care services. (Yearbook of Australia 2006) Health financial support from the Federal Government rely heavily on the income tax to the Government revenue. In the 2004-05 financial year, government revenue accounts for about 75.6% from income taxes, personal income taxes, corporate taxes and other income taxes are accounted for and the 52.3%, and 3.8%. (2005-06 Budget) Launched in 1984, “health care plan”, the introduction of a compulsory “health care plan” levy to add other taxes in order to meet the Federal Government “health care plan” the extra cost of providing universal health care. Australian Tax Office is responsible for collecting “health care plan” levy. Levy rate from the original account for more than a specified amount of income tax 1% of taxable income, respectively, rising to 1.25% in 1993 and 1.4% in 1986. Since 1995, the “health care plan” the levy rate has remained at more than a specified amount of income tax the taxable income of the 1.5%. Browning (2000) and Biggs (2004) Set the amount of income tax is to ensure that low-income individuals and families exempted from the payment of “health care plan” levy. Since the 2004-05 fiscal year, the Government does not have annual revenue collection of individuals and families, “health care plan” levy. Authorities in respect of each dependent child or children. The Australian Government through tax rebates, “lifelong health care plan” and “health care plan” tax surcharges, to encourage people to buy health insurance. Since April 1, 2005, the Federal Government will be 65-69 Australian health insurance rebate rate was increased from 30% to 35%, and the rebate rate for people over 70 years old increased from 30% to 40%. Australia Office of the health-care plan is a statutory body, on behalf of the Federal Government “health care plan”. (Prime Minister of Australia (2004))
New Zealand
New Zealand Labour Party Government in the 30 \’s when the global recession will soon be over, the 1938 Social Security Act was enacted, to develop a comprehensive health care system, to all New Zealand provides free health care services. New Zealand tax before 1947 has set up funds to primary health care system, providing users with public and private health care services, most services free of charge. The central allocation and management of the continuing operation of the health care system in decades. (French, Old and Healy (2001) and World Health Organization (2004) New Zealand\’s health care financing system is to tax-based financing system, financed mainly from the General Government expenditure on health services. Through the budget process, of public funds allocated to the regional medical Commission for medical uses. Meanwhile, the accident compensation Board as employer, income generation, and cars owners to collect levies to buy accident-related health care services. The general revenues of the Government (including the health resources) from personal income tax, goods and services tax and corporate tax. In the 2005-06 fiscal year, personal income tax, goods and services taxes and corporate taxes is expected to total revenue, respectively, 43% and 17%, accounted for an estimated revenue of 79%.
Singapore
Singapore independence in 1965, leave us and UK tax and public medical services of the health care system. At that time, the health care services provided by public institutions, funded from general taxation, the public can enjoy free medical services, or pay only the nominal fee. (Lim (2004) and Hanvoravongchai (2002). Major health care financing reform, started in 1984, with changes to tax-based financing system, Singapore chose to establish a medical savings account system. Announced in 1983 on the ground that the national health plan in 1984, under the Central Provident Fund system set up health savings accounts. The health system has been implemented so far. Employees and employers are required to make mandatory contributions to health savings accounts. Cumulative deposits of individual health savings accounts can be used to pay the account holder and/or immediate family members of hospital bills. Aw and Low (1997) and Phua (1991) Singapore Government providing tax concessions to encourage employers to provide health benefits to employees. The implementation of “the portable medical benefits scheme” or “portable health insurance plan” employers will receive tax concessions relating to total salary expenditure for the financial year 2%. On the effectiveness of the system of medical savings accounts, some scholars have pointed out that although Singapore adopted medical savings account system since 1984, and employer-provided benefits, financed by the Government and individual out-of-pocket payments, health care savings, “health care plan” and “medical funding” together provide the proportion of health care resources is still low. Some scholars believe that the benchmark to measure the effectiveness of the system is that Singapore in medical savings accounts under the system of health care expenses, lower than taxes for health care expenses in the financing system.
Canada
Canada\’s health care financing system in tax-oriented, health care services are funded mainly from federal and provincial governments the general purposes of the Government, especially the latter. (Canadian Institute for Health Information (2005c)) Health care financial support mainly from reliance on income tax, consumption tax and corporation tax to the Federal Government and provincial government general revenue. (Marchildon (2005)) Canada medical cash grants and tax funding both components. Taxes are indirect funding, this is imposed by the Federal Government will have to reduce their own tax rates, provincial tax rate reduction by the Federal Government to increase the tax rate, which should flow into the Federal Government\’s tax revenue directly into the provincial government. If the Federal Government decision to grant Canada health care funding, cash tax funding will be announced in the budget. (Federal Transfers to Provinces and Territories (2006)) Federal Government and the provincial Government accepted the Committee of recommends, agreed retained now to tax for this of medical financing system, that put medical service divided for two class: in Canada medical method Xia was column for in insurance range within of medical service, these service completely by public funding; and no was column for in insurance range within of medical service, these service most by private funds provides funding. Some scholars pointed out that Canada one of the characteristics of the health care system, a number of health care services (that is, insurance for hospital and physician services) fully supported by public funds, other services (for example, a number of professional health care services) is mainly financed from private funds, such as out-of-pocket payments and medical insurance schemes. (Flood, Stabile and Tuohy (2002))
United Kingdom
In United Kingdom, since the establishment of the national health system, most funding comes from general tax revenues. The NHS Plan policy document on the following health care financing alternatives, including: providing incentives to encourage nationals to take out private medical insurance; a new medical fees; to tax-based financing system into a social health insurance system and confined to the health care services provided by core services. The NHS Plan policy document concludes: the national health system to tax-based financing system should be maintained, since this system proved effective and in line with the principle of fairness. (The NHS Plan (2000)). National system of health care service delivery systems by a variety of statutory organizations, particularly health policy authority and primary care trust. All of England is divided into 10 districts, each district set up a medical policy Board, responsible for services ranging from 2.5 million to 7.4 million population in the region. Governance each health policy Authority Board of Directors consists of 8 to 13 appointed members. Medical policy Board does not provide health care services, within its primary responsibility is to monitor the provision of public health care services. When in the discharge of its supervisory duties, health policy authority will ensure that primary care trusts to comply with the policy direction set by the Government, and will monitor the performance of primary care trusts. In addition, health policy authority is responsible for establishing strategic direction, and to improve the provision of public health care services. Government\’s general revenue, mainly from income tax, goods and services tax (VAT) and corporate taxes. 2004-2005 financial year, income tax, goods and services tax and corporate tax is estimated to total revenue, respectively, and 34% and the 9.1%, which accounted for an estimated revenue of 62.5%. (Office for National Statistics (2005)) Employers, employees and self-employed persons are required to rate fixed by the Government to make contributions to the national insurance scheme. 2006-2007 fiscal year, an employee has ranged from 84 pounds and 645 pounds 11% to the weekly contributions beyond £645 1% all week of contributions to employers in respect of employees beyond 84 pounds 12.8% all week of the contribution. Employer from employee salary deductions from the employee\’s contributions, and then to the United Kingdom revenue and customs to pay the money and employers \’ contributions Contributions of self-employed persons is divided into two sections per week fixed amounts and as a percentage of annual earnings. Fiscal year 2006-2007, weekly amounts to 2.1 billion. Between £5,035 and £33,540 annual earnings to be made 8% contributions beyond £33,540 all annual profits shall be made 1% contributions. Self-employed persons are subject to quarterly United Kingdom revenue and customs to pay the fixed rate contributions contributions relating to annual earnings is paid once a year. (Background to National Insurance Contributions (n.d.) and Rates and Allowances – National Insurance Contributions (n.d.).
Taiwan
Taiwan\’s health care financing system are included in the category of social medical insurance system. Under the social health insurance system, funding for health care services is primarily from compulsory contributions. According to the law on universal health insurance, insured persons and employers were required to contribute to the national health insurance scheme, and the Government will have to pay premiums for the part of the insured. (Bureau of National Health Insurance (2006) and National Health Insurance Act. In addition to insurance, national health insurance plans there are two sources of funding, that is donated for health and welfare and the public welfare Lottery distribution of income. Since 2002, the Administration levied on tobacco products health benefits donating. 94 article 22nd of the tobacco and alcohol tax law stipulates that such surcharges collected by the 90% shall be allocated to the national health insurance scheme. In 2004, 1.9% of the national health insurance plan income from that source of funding (National Health Insurance Act, Tobacco and Alcohol Tax Act, Regulation of the Distribution, Utilization of the Health and Welfare Surcharge on Tobacco Products and Bureau of National Health Insurance (2005b)) In health care financial support from the Government rely heavily on the income tax, business income tax and commodity tax General. In FY 2004, 61.2% of general revenue comes from income taxes, business taxes and commodity taxes, 3 proportion of taxes were 32.9%, 16.8% and 11.5%. (Yearbook of Tax Statistics 2004)
Sweden
Sweden to adopt universal health coverage in 1955. 58% of national income tax to the Government, of which 11% is in public health expenditure. Pay attention to the government\’s health spending is 66% of the countries tax-financed by the county. In fact, the local government attaches interventional medical services provided by the Government, spending on average accounted for 85% of the budget. Management of medical services has become the focus of local government affairs, politics and elections. Local government, county County Council to provide these services, or outsourcing to a growing autonomy of public providers. Private practitioner based services on the part of the fee paid to obtain. (Medical care system of the European Observatory 2002)
Sweden now medical financing system, and the 19th century very different from the voluntary insurance system at the time. In 1885, the working population of 10% participated in the “friendly society” Member ill be entitled to sickness benefits. The second half of the 19th century, employers have diseases Fund for workers. Unions then follow suit, I hope Members relied less employer-based plans, have more independence. (P. g. Edebalk and J. Olofsson 1999).
In many respects, Sweden\’s health care system is successful. National\’s health continues to improve, average life expectancy is 80.4 years (medical care system of the European Observatory 2002), is one of the world\’s highest life. System of universal coverage (dental services for persons over the age of nineteen limited), welfare and comprehensive – a nominal fee, only 2% of total public health expenditure. System has great acclaim, wholeheartedly endorsed the principle of universal coverage. Voluntary health insurance negligible, only less than 1% of the population. But private practice quite common in the city, can contribute to the social security system claims. (Medical care system of the European Observatory 2002), government health spending accounted for 6.5% of GDP – slightly higher than the average (5.7%), the UK (5.9%) and the OECD countries.
In any event, the domestic cost, quality, using the pace of new technologies, and the waiting list of grievances in the past contributed to countless transformation. This includes a limited increase his own expense, but mainly focus on improving the efficiency and to separate the purchase and provision of services to control costs. Stockholm is the only place to put a public hospital sold to private companies. Services provided by the county county reorganization of public non-profit mostly new forms of management. Sweden also try founded “Internal Market” – public providers to compete with each other – let people choose the provider. It spanned migration is restricted by special conditions; for migration to divert funding only 2-5% of all funds. Even so, small-scale migration of politicians and managers is a major event, it will cause great concern and respond provider. (C. Rehnberg 1995)
In Australia and New Zealand, general medical expenditure of total medical expenses: 68% and 78.3% respectively. Although the two local public expenditure on health care as most come from general tax revenue, their taxes have different proportions of individual sources. Australia relied heavily on income taxes, New Zealand are dependent on the income tax and the goods and services tax. In Canada and the United Kingdom and Taiwan, General of total medical expenses medical expenses respectively about 70%, 83% and 64%. Selected places most public expenditure on health care from general taxation, and main source of revenue for income tax, corporate tax and goods and services. In Hong Kong, health care resources are mostly from general tax revenues, while general tax revenues rely heavily on income and profits tax. 2005-2006 fiscal year, income and revenue from profits tax accounted for 80% or 56% all government revenue. At present, the narrow tax base, the Government and low tax rate based on the provision of public health care services to the people of Hong Kong enjoy. Some scholars have suggested that, if Hong Kong is to maintain the present low tax rates, high finance and high quality policy, the health care system may not be able to continue. In the circumstances of Hong Kong, maintain the same symptoms continued to use the existing financing arrangements, that is said to continue to rely on government revenue to meet required ever-increasing expenditure on medical services. Unless the government are prepared to accept the public hospital service level and quality will drop significantly, this meant the Government would have to raise revenues. Assume that the government can\’t continue to cut public spending in other areas, the Government will have to take into account one or more of the following measures, including raising tax rates, broaden the tax base and increasing tax revenues. Insofar as the present medical system, if the government had to rely solely on government income under proposed to cope with the current medical system for additional public medical expenditure, by 2033, total public spending be increased to 22.1% per cent of GDP, while public expenditure on medical care will be increased to 24.8% per cent of total public expenditure. To pay for public expenditure growth needed to increase government revenue, and that means the government have to increase substantially salaries tax and/or profits tax rate, unless the government introduce new sources of income such as broadening the tax base, or increased tax revenue. And significantly increase the total public expenditure is also in contravention of existing restrictions on public expenditure in the GDP of 20% policy. The other hand, total public expenditure of GDP remained at 20%, 2033 public medical expenditure as a share of total public expenditure of 27.3%, effects of other public services allocation. (For example, education, social welfare and security respectively of total recurrent government expenditure in 2008-09-23.8%, 17.6%, and 11.8%, the ratio might be reduced in the future. Revenue directly to the medical services financed by the Government, in addition to Hong Kong, but also Australia, Canada, and Finland and the United Kingdom the main financing way. 16% personal income tax levy and Hong Kong (2007-08-salaries tax standard rate), all personal income tax rates in the advanced economies is much higher, not including social security contribution rates ranged from 40% to 48.8%. These economic systems of sales tax as a revenue source, its share of public expenditure in GDP is also higher in Hong Kong, rates ranged from 34% to 51%, and Hong Kong (2004-05) rate of 19.7% per cent. Comparable to that of Hong Kong, the economic system of publicly-funded medical care system has had to face the aging of the population and advances in medical technology, resulted in this major challenge of rising costs of medical services. This problem in a charge by the service model of Canada more severe, because this mode to make the authorities more difficult to control the use and cost of services. Faced with these challenges, which have a different reaction. Canada has been arguing theoretical advantages on the expansion of the private medical sector, including private medical service providers to provide more services and private medical insurance medical financing higher proportion, but action has not yet been achieved a total of knowledge. Australia said in the future, the Government\’s response was to encourage people to take out private medical insurance, to reduce the demand for public hospitals. United Kingdom response with a substantial increase in public expenditure on medical services. This is mainly due to United Kingdom consciousness, compared with most other Western European countries, United Kingdom in the past 20 years at least inadequate funding for medical services. However, it was concerned that United Kingdom Government face large deficits in the future, can maintain the level of expenditure on medical services.
CHAPTER 3 RESEARCH METHODOLOGY
To carry out this investigation, are a particular focus for public comment because the current financing model and supplementary funding to select the health care reform. Purpose of the survey include: (a) evaluate different financing options to each group, including six different supplementary financing options and tax increases; (b) identify the relative preferences between the different financing options (c) understanding of the root causes, from the perspective of individual and social point of view, the most preferred choice of people and at least preferred option. (d) knowledge of key facts and characteristics of the person to assess the options. (e) Evaluation of people\’s knowledge and their advantages and disadvantages and the most affected their understanding of the preferred option least preferred option as health care financing options. Financing and supplementary financing and tax comparisons between different properties of the six options.
Research Design
Research three methodologies to explore feasibility and impact of health care financing in Hong Kong. These methods include, first of all, questionnaires will be issued to Hong Kong citizens in the age of 18-60, and second, analyzing structure of income and expenditures, and budgetary policy in the Hong Kong Government, to discuss the need for tax reform, third, analysis of health care financing in different countries and social impact. Finally, from the perspective of consumption of the general public acceptance and preference of the various design features and financing of health care choices.
Questionnaires distributed via the Internet and invite all Hong Kong citizens, interested aged 18 or more people. This research method provides easier collection, classification and analysis of information, but also facilitate the candidates to fill in the questionnaire, they can each complete questionnaires and everywhere they want. Respondents are just on the car Internet from their computer, even smart phones also can fill in the questionnaire. It can also lead to increased participation rates.
Survey target person does not handle any filter, so all comments and questionnaire statistical results can provide without bias, it makes our analysis more objective.
Use the main sources of information in the questionnaire, the questions designed and distributed to Hong Kong to collect their views on spending behavior via the Internet purpose and affect the impact if you use the main source of health care financing. Target people are aged 18 or over, this sector who belong to a high proportion of the working population, consumer behavior perspective of this sector provides the more representative.
Questions was to investigate the financing of health care knowledge and behavior of the Hong Kong people. According to the voluntary health insurance scheme, referred to the information in the contents of the consultation document, the Hong Kong Government is interested in sets of six choices, so, questionnaires were also around these six choices.
In the fourth part, the results of this paper is to show the details of the data, gathered from the questionnaire, this article will use charts to explain the results to make it easier to understand.
Provided by the questionnaire aims to gather opinions on health care financing. Analysis on the problem of health care financing, personal information is also used to make a graph, for analysis. Sample of the questionnaire attached to the end of the Appendix.
From first third question, the main reason is to analyze the public financing of health care needs and their generous behind. In the next 13 questions, mainly focused on medical financing behind her core values, their orientation
In the next 6 questions, the public focuses on the different types of supplementary healthcare financing scheme generous understanding. The remaining part of the analysis of the public health care financing plan choose different possibilities made
Quantitative Information
The information provided quantitative information collected mainly from Hong Kong government and foreign government websites, revenue, expenditures, gross domestic product index, the rate of decomposition of materials and other more detailed data, and for the long period, allow me to explore the structure and assess the future the potential problem. In addition, in the textbooks, but also from the authority of the Internet article, report information for the development of a comprehensive evaluation.
Primary Information
This research paper requires the practical data, actual data, and make a comparative analysis.
Research Method
The method used questionnaires to collect views on health care financing and spending behavior, its impact. Questionnaire survey was conducted via the Internet platform to invite the target of respondents who are willing to compete. It covers such as the Yes (agree) / No (disagree) problem, technical five-point scale and a wide selection of integrated issues.
Validity
Reference documents consulted questionnaire tax reform, as well as previously done by other researchers believe that research, it is appropriate to ensure that the views from the questionnaire for the analysis of useful, objective results.
Reliability
Survey target person does not handle any filter, so all comments and questionnaire statistical results can provide unbiased, it makes our analysis more objective and reliable. In addition, the views from the questionnaire via the Internet to collect before submitting files within a month, which is believed to improve higher reliability.
Generalizability
A total of 300 respondents were randomly distributed respondents, including gender, age, occupation, income and education levels. The results do not provide significant bias.
Sampling
The target number of questionnaires is 200 pc or more. A total of 300 questionnaires distributed to target respondents and the last received 207 questionnaire. The response rate was 69%. Questionnaire sent to Hong Kong citizens over the age of 18-80.
Secondary Information

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