An important debate took place this week in the Legislative Assembly. The specific topic was the possibility of setting up a universal health insurance system. More broadly, it was about the health of residents and how to pay for it, which is indeed a worthy topic. That importance only grows more if we bear in mind the region’s demographic trends.
The member of the government in charge of health affairs was at the Assembly to answer legislators’ questions. The debate was more substantial that is often the case in similar situations. Inevitably, there will be another study. No doubt, studies are essential for policy setting and may we be spared the implementation of policies that are not adequately designed and assessed beforehand. But past examples from all levels of the Administration make some of us wary of promises of yet another study that ends up as no more than delaying, if not forgetfulness inducing, tactics. Hopefully, this will not be the case.
The Secretary submitted ideas and comments that suggest the issue has already been given some thought. How much that will increase the chances of seeing some sort of universal health insurance making its way onto the statutes is an open question. The debate also suggested that there is opposition in some quarters to the idea. That resistance extends, possibly, well beyond the confines of the services under the Secretary. But at least there is an attempt to properly frame the discussion.
First, we should not seek change for the sake of change. We have to start by asking scrupulously how good or satisfactory the existing system is. How can it be improved, in small or big ways, and what costs and administrative adjustments would that entail? Then, what are the alternatives and models of reference? Germany may not be a good reference, Singapore possibly might. What benefits could they bring, at what cost? How should the responsibilities and financial burden be distributed?
Some of the right questions are being asked, which is a good start. One can never get good answers to poorly designed questions. Let us hope the debate proceeds openly and maintains focus on efficient approaches to improving the existing system in ways that deal with the foreseeable evolution of needs. Macau is fortunate enough to be able to do that in a situation where the state of the public finances is the least of its concerns.
