Among developed countries, Hong Kong is so far out in front there isn’t even a close second. Or at least it would be if (a) it were still an independent country and (b) I used the measuring rods commonly used by critics of the US system, including the Commonwealth Fund, the World Health Organization, SiCKO and the Mercer/BRT study described below.
Why does Hong Kong rate so high? Because:
- It has the lowest infant mortality rate in the whole world and the second highest life expectancy rates; and
- At 5.2% of GDP, its health care spending is about half of the OECD average.
Also, all medical students are trained to use electronic medical records and, at least in the public hospitals, they actually use them.
So why aren’t we hearing about Hong Kong from Michael Moore, Hillary Clinton, Barack Obama and all the other critics of American health care? Maybe because Hong Kong has (a) one of the smallest public sectors (government spends only 55% of the total), (b) very little health insurance (only 12% of spending) and (c) the highest amount of out-of-pocket spending among developed countries (one out of every three dollars).
Basically in Hong Kong people can “purchase” public health care for very nominal fees, but potentially lengthy waits. For example, the average wait to see a specialist is more than 7 months. The average wait is 2 to 3 years for Lasik surgery and 4 to 5 years for cosmetic surgery. Or, patients can turn to much more pricey care in the private market. The public sector offers low money costs, but high waiting costs. The private sector offers high money costs with very little waiting.
So what is Hong Kong doing with its health care system? Trying to reform it, of course. To my knowledge, every government in the whole world is trying to reform its health care system – no matter how well it works, or doesn’t work.