OBJECTIVE. To evaluate the viability of the Health Protection Account proposed by the Hong Kong Special Administrative Region Government.

DESIGN. Retrospective study.

SETTING. The Hospital Authority of Hong Kong.

MATERIALS AND METHODS. Data were obtained from hospital and specialist out-patient clinic admissions. The expected health cost for each patient from the age of 65 years to the average age of life expectancy (83 years) was estimated, as was the contribution to these health costs from the Heath Protection Account.

RESULTS. If individuals contribute 1% of their salary to the Health Protection Account from age 40 to 65 years, the Account can only cover 4% of the actual health costs.

CONCLUSION. The Health Protection Account, as proposed, does not ease the financial burden of increasing health care costs in the elderly. Increasing the contribution rate or reducing the age at which contributions to the scheme are started are possible viable options for making the scheme sustainable. However, the current economic situation is such that the public would not favour either of these alternatives. It is envisaged that the Government will need to continue to finance the health care of its citizens by taxation. A gradual increase in user charges might be the only future option for controlling government health expenditure.

Key words: Delivery of health care; Health care costs; Health expenditures; Hong Kong

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