Special Report – The ever-growing health budget 

The health budget was MOP1.1 billion in 2001; now it’s MOP12 billion and could double in 2024 with the new hospital in operation

MB July 2021 Special Report | A patient hospital

Irish researcher Michael O’Regan, Bournemouth University (UK), published a paper last year on the current social situation in Macau (Post-Colonial Macau: hope and despair in a World Center of Tourism and Leisure).

His research included interviews of two dozen residents in Macau.

Mary, 23, argued that “although the government offers many monetary benefits to citizens, the soft benefits and compensation are not enough. The quality of medical treatment in Macau is so terrible that people must go to Hong Kong and China for treatment when they get ill. And even though you just have a cold, you have spent too much time waiting for treatment in the public hospitals”. On the other side, Chris, 59, claims that “it is very difficult to consult a doctor as it takes a very long time, even to book a date [to see a doctor].”

These two statements alone are not sufficient to conclude there is widespread dissatisfaction among residents over the health services provided by the Government, but there are further elements we can add.

“Both civil society and the government speak for themselves, but citizens’ sense of happiness in relation to health services cannot be reflected in public opinion, which in fact warrants study and greater attention on the part of the Government and the health sector,” lawmaker Chan Iek Lap, the only doctor sitting on the Legislative Assembly, believes.

Perhaps this is why the Policy Address for 2021 reveals that last year the Health Bureau launched an investigation into the circumstances in which residents turn to medical services and the level of health protection, along with a feasibility study for the operating models of the Islands Medical Complex.

“Citizens’ sense of happiness in relation to health services cannot be reflected in public opinion, which in fact warrants study and greater attention on the part of the Government and the health sector” – Chan Iek Lap

Ho Iat Seng revealed last year that the health care budget rose to MOP12 billion in 2020 (in the first years following the Handover, Macau spent MOP1.1 billion on health care, a figure that stood at MOP8 billion 15 years later). The Chief Executive also announced that, with operation of the Islands Medical Complex, medical expenses would increase by a factor of 1.5 to 2.

“The steady increase in health expenditures can be seen as a ‘big white elephant’, as citizens do not feel there have been significant improvements in access to health care, the waiting time remains long in the case of particularly serious or urgent illnesses and the effects of treatment are not satisfactory, prompting some citizens to leave Macau to seek out treatments and doctors and incurring heavy expenses,” lawmaker Si Ka Lon said this year.

Even so, Macau spends far less than the models it usually takes as reference: for example, annual health care expenses in Macau account for about 10 per cent of total government expenditure, whereas in Singapore that figure reaches 13 per cent, in Hong Kong 16 per cent and in Taiwan 25 per cent (Taiwan has a comprehensive universal health protection system).

Healthcare Subsidy Scheme: “tremendous support”

The Healthcare Subsidy Scheme, created in 2009, “has always deserved recognition from the general population, as it has not only reduced both residents’ burdens and, to some extent, waiting times for consultation, but has also promoted the general development of the private health sector,” lawmaker Zheng Anting believes.

The legislator adds, however, that “as health care needs vary according to different age groups, the Government is expected to make an appropriate adjustment to the health vouchers policy in line with the needs of residents.

“Many residents have told me that it is the elderly, for the most part, who suffer from chronic illnesses and have weak resistance to even the most frequent mild illnesses. Due to their age, they are more likely to suffer from problems with their teeth and eyesight. But, as private medical consultations are more expensive, even if the elderly use their own health vouchers plus those of their family members, it is not possible to cover all expenses and the health vouchers of the majority of the elderly are exhausted in the first months,” Zheng Anting wrote to the Government.

“As the current amount of health vouchers is not enough to meet needs, most elderly people opt for the public health system, so waiting rooms are still full,” Zheng Anting continues, asking “the authorities to improve the health voucher plan.”

In 2009, when the Healthcare Subsidy Scheme was launched, each permanent resident received health vouchers worth MOP500. In 2013 the value went up to MOP600.

The Health Bureau’s response to legislator Zheng states that since then, “the program has been improved, namely with the implementation of electronic health vouchers and the extension of the period of use to two years, facilitating use by residents,” adding that “since the implementation of this program, there has been tremendous support from both residents and the sector, and in general the program has been successful.”

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