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■市民參加政府推出的自願醫保計劃，可節省輪候公營醫療機構的時間，同時當局亦可減少公共醫療的支出。 資料圖片
社評雙語道 行政會議通過全民自願醫療保險建議。我們認為，計劃成功的關鍵在於能否吸引中產階層積極參與。政府應考慮給予醫保供款稅務寬免，增加中產階層參與計劃的誘因，讓更多中產人士可得到適切的醫療服務，同時產生分流病人的效果，減輕公營醫療和公共財政的壓力。
本港公營醫療負擔沉重，在人口不斷老化的趨勢下，更有難以為繼的隱憂。自願醫保計劃主要是面對中產階層，希望透過計劃將中產分流到私營醫療市場。根據政府推出的自願醫保計劃，投保人月費只是120元至450元不等，65歲或以上長者、長期病患及精神病患等高風險人士均可投保，而且保費可獲政府資助，對中產有一定吸引力，參加自願醫保計劃可避免公營醫療機構長期輪候之苦，而且因為有政府包底，投保的賠償也更有保障。
自願醫保的主要對象是一眾中產階層，如政府以扣稅優惠吸引中產參加自願醫保計劃，相信將可提升中產階層對計劃的興趣。有意見指，政府已為自願醫保計劃提供補貼，中產參加計劃可享稅務優惠，等同享受雙重補貼，政府庫房會因此有所損失。可是，中產階層是本港稅收的主要支柱，向來納稅最多，但得到政府的資助最少，以稅務優惠吸引中產參加自願醫保，既是對中產的體恤，亦能體現公平原則。稅務優惠可真正發揮分流病人的作用，幫助中產階層之餘，又可提高計劃的成功率，以及減少公共醫療的支出，可謂一舉數得。當局應從大處著眼，以稅務優惠鼓勵中產參加自願醫保。
The Executive Council has approved the whole population voluntary medical insurance scheme proposed by the government. We believe the key to the success of the scheme lies in its ability to attract the middle class to actively participate. The government should consider offering tax exemption on the insurance premium as an incentive so that more in the middle class will join the scheme to get timely and appropriate medical care while at the same time diversion of patients can be achieved to alleviate the pressure on public medical services and public finance.
The public medical system in Hong Kong is overburdened and with an aging population there is the risk that the existing services may not be able to sustain. The voluntary medical scheme is targeted especially at the middle class and it is hoped that under the scheme the middle class people will be diverted to the private sector and seek medical treatments in privately-run facilities. According to the proposed voluntary medical insurance scheme, the monthly premiums to be paid by the insured will be merely between HK$120 and HK$450. In addition, high risk people including senior citizens at the age of 65 or above, chronic disease patients and mentally-ill patients can also enter a policy and receive subsidy from the government. So, to a certain extent, the scheme is quite attractive to the middle class. By joining the voluntary medical insurance scheme, the insured no longer need to queue and wait for a long time to get treatments in public health facilities. As the government is going to act as the ultimate underwriter, the indemnity will be further secured.
The main target of the voluntary medical insurance scheme is the middle class. It is believed that if the government can offer tax deduction as an incentive for this health scheme, the middle class will have a greater interest in joining. Some have the opinion that as the government has already provided subsidies to participants in the scheme, further tax benefits for the middle class will mean double subsidies and this renders a loss of revenue of the Treasury. However, the middle class, being the prime source of tax revenue in Hong Kong, is the group that has always contributed the largest share of tax payment while receiving the least help from the government. Offering tax benefits to attract them to join the scheme is not just a gesture of appreciation but an application of the principle of fairness. Tax incentives can help to achieve diversion of patients. Besides giving help to the middle class, they can boost the success rate of the scheme and reduce public healthcare expenditure. The gains are manifold. Therefore, the authorities should consider the issue from a wider perspective and encourage the middle class people to join the voluntary medical scheme by offering tax benefits.
■translation by開明 chi.ming818@gmail.com
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