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Intent is to make 'privately financed' health remedies more accessible

The Community Care Fund (CCF) has initiated a second phrase of its medical assistance programme, providing hundreds of patients with extra funding to buy self-financed medicatons. The Hospital Authority plans to merge the ad-hoc scheme into its regular safety net system.

Not everything is free at public hospitals and the CCF wants to make costly remedies more accessible. There are some effective but expensive pharmaceutical products listed as "privately purchased medical equipment or appliances".

Patients lacking the financial means were able to obtain subsidies from the Samaritan Fund for 20 self-financed drugs.

Cheung Wai-lin, director (cluster services) of the Hospital Authority, said over 60 percent of applicants have received a full subsidy, but many simply dropped out of the safety net because of failing the asset test.

Other than the clinical requirements, applicants are also screened by medical social workers for the annual "disposable financial resources" of the applicants' households.

Applicants will decline if the annual cost of their drugs is at or lower than 30 percent of their household's disposal resources. For example, if the household has HK$1 million and the drug costs HK$300,000, the patient is denied.

Starting from Jan 16, patients will be able to turn to the CCF for a second layer of the safety net, on top of the Samaritan Fund, which will continue to operate as usual.

The CCF will now provide subsidies to applicants whose drug costs lie between 20 to 30 percent of their hosuehold's disposal financial resources, effectively lowering the "contributing ratio" of the Samaritan Fund.

In the illustrated example, the patient would receive an extra HK$100,000 from the CCF because he would be expected to spend not more than 20 percent of the household's resources for his medication. Several hundreds of patients can fall back to the safety net of self-financed drug as a result.

One hundred and forty patients held by the Samaritan safety net are also expected to receive greater subsidies. As with the 10 patients who received the CCF's first phase of sponsorship on cancer drugs, they will all be informed of the new CCF support via letters.

The total expense of the second phase is expected to be HK$9 million, though there is no limit. Anthony Wu Ting-yuk, chairman of Hospital Authority, said the CCF is playing a transitional role in bringing a lower threshold to the Samaritan mechanism.

Tim Pang Hung-cheong, community organizer of Society for Community Organization, welcomes the lower threshold, but proposed more fixes to the Samaritan Fund for the authority to consider.

As the entire household is now put into account for the Samaritan applicants, savings of parents and siblings are also considered part of the disposable resources. The number easily overflows, but Pang said resources like retirement savings are often not that disposable at all. The Hospital Authority held that family members helping each other is not very realistic in practice.

Clinical criteria for the fund are also flexible. Subsidies for self-financed drugs only come down to the patients when their condition reaches a specific severity, but Pang pointed out absence of the self-financed drugs might just cause deterioration.

kahon@chinadailyhk.com

China Daily

(HK Edition 01/13/2012 page1)