Proposed cap on how much Hong Kong’s elderly can spend on eye tests leaves optometrists fuming
- Health officials suggest HK$2,000 limit for medical vouchers scheme in bid to stop patients from spending money all in one place
Hong Kong health officials have proposed a HK$2,000 cap every two years on the value elderly residents can spend on optometric services using their medical care vouchers, drawing ire from the industry.
The government had initially considered a HK$1,000 cap, but raised it after consulting patients’ groups and optometrists.
The idea, according to Secretary for Food and Health Sophia Chan Siu-chee, is to discourage the elderly from spending all their vouchers on a single service, and to ensure a “decent balance” was kept for other pressing services, such as body check-ups and chronic illness prevention.
A recent review showed that more than three quarters of claims above HK$4,000 were made at optometrists last year, a worrying trend that could undermine the scheme’s effectiveness in promoting a more diverse use of primary health care services.
“Our review has shown that each claim for optometric services has been disproportionately high in terms of per claim amount and total expenses,” Chan said.
“[We hope] the elderly can make better use of elderly health care vouchers, and not concentrate or over concentrate on one particular service.”
The median claim at optometrists from 2015 to 2018 was between HK$1,600 and HK$1,951, compared to between HK$550 and HK$640 at regular doctors.
And, out of the 235 complaints received in this period, 46 were directed toward optometrists, a figure which Chan said was also relatively high.
Under the existing scheme, introduced in 2009 and regularised in 2014, eligible residents aged 65 or above are given a HK$2,000 voucher annually to help pay for certain medical services in the private sector, to serve their health needs and lower the burden of the city’s public system.
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Any unspent voucher amount can be carried forward up to a limit of HK$5,000.
Critics have long highlighted potential for the misuse of vouchers, such as unnecessarily expensive eye exams and spectacles, or even exorbitant prices for dried seafood products at Chinese medicine clinics.
There were 5.18 million voucher claim transactions last year, up from 3.48 million in 2017. Around 60 per cent of these claims were for visits to doctors, compared to 7 per cent for optometrists.
But voucher claims for optometric services accounted for 27 per cent of the HK$2.8 billion in total voucher claims last year, compared to 41 per cent for regular medical doctors, 20 per cent for Chinese medicine practitioners, and 10 per cent at dentists.
The Hong Kong Association of Private Practice Optometrists lashed out at Chan’s proposal, and claimed the move would force elderly people to pay more of their own money for eye exams.
A survey of 300 elderly people indicated that more than half would not pay out of their own pocket for an eye test, while 90 per cent objected to the HK$1,000 limit.
Jeffrey Pong Chiu-fai, president of the Ophthalmological Society said the government should be clear about what constituted medical services under the voucher scheme, and questioned the definition of health care products, asking why sunglasses were included while suntan lotion was not, when both could block UV-rays.
Civic Party lawmaker Dr Kwok Ka-ki urged the government to put more resources toward monitoring and limit the use of vouchers on other “inappropriate” health care products and services, such as dried seafood.
“If not, it would appear that the government is regulating optometric services but letting others off the hook,” he said.
The Society for Community Organisation welcomed the proposals, but was concerned the move would reduce the flexibility of how some elderly people were able to use their vouchers.
