Current Practices in Managing Health and Health Care

Hey everyone! Welcome to your study notes for this super important chapter. Ever wondered why some people go to a public hospital, some go to a fancy private one, and others get help from a community centre? It's all about how healthcare is organised and paid for in our society.

In this chapter, we're going to explore the three main ways health services are delivered. Understanding this is key to understanding why healthcare can be so different for different people. Don't worry if it sounds complicated – we'll break it down with simple examples you can relate to. Let's get started!


The Three Main "Players" in Healthcare

Think about getting lunch. You have different options:

  • A school canteen: It's affordable and available to all students. It's not fancy, but it gets the job done.
  • A restaurant: You have lots of choices, the service is fast, and the environment is nice, but it costs more.
  • A charity kitchen: It provides free meals for those who can't afford them, focusing on helping people in need.

Healthcare works in a similar way! There are three main models for providing care:

1. Government Services (like the school canteen)

2. Profit-Making Services (like the restaurant)

3. Charity-Based Services (like the charity kitchen)

Let's look at each one more closely.



1. Government Services: Healthcare as a Right

This is also known as the public sector. The main idea here is social entitlement. This is a key term!

What is Social Entitlement?

Social entitlement means that citizens have a right to certain services provided by the government, simply because they are part of society. The government has a responsibility to provide a "safety net" to make sure everyone can get basic healthcare, no matter how rich or poor they are.

How does it work?
  • Funding: It's mainly funded by public money (taxes). Everyone who pays taxes contributes to a big pot of money, and the government uses that money to run hospitals and clinics.
  • Goal: The main goal is equity and accessibility. This means providing fair access to healthcare for the entire population at a low cost. It's not about making money.
  • User Groups: Everyone can use these services! However, they are most crucial for low to middle-income families, the elderly, and people with chronic (long-term) illnesses who need regular, affordable care.
  • Ability to Afford: Services are heavily subsidised, making them very affordable. For example, in Hong Kong, a visit to an A&E department at a public hospital costs a small, fixed fee, even if the real cost of your treatment is thousands of dollars.
Real-World Examples in Hong Kong:
  • The Hospital Authority (HA), which manages all public hospitals (like Queen Elizabeth Hospital, Prince of Wales Hospital).
  • Government-run clinics for family health or dental care.
Quick Look: Pros and Cons

Advantages (Pros):

  • Affordable: Protects people from huge medical bills.
  • Comprehensive Care: Can handle very serious and complex medical problems.
    • - Accessible to all: Provides a crucial safety net for everyone.

Disadvantages (Cons):

  • Long Waiting Times: You might have to wait months or even years for non-urgent surgery.
  • Less Choice: You usually can't choose your specific doctor.
  • Crowded Environment: Wards can be busy with many patients.
Key Takeaway

Government health services are built on the idea that healthcare is a basic human right. They aim to provide affordable care for everyone, but high demand can lead to long waits.



2. Profit-Making Services: Healthcare as a Business

This is also known as the private sector. Think of these services as businesses that sell healthcare.

How does it work?
  • Funding: It's funded directly by patients or through private health insurance. It's a "user-pays" system.
  • Goal: The main goal is to make a profit. They compete with each other to attract patients by offering better services, more comfort, and newer technology.
  • User Groups: Typically, these services are used by higher-income individuals, people with good company health insurance plans, or anyone who wants to avoid the long queues of the public system and is willing to pay for it.
  • Ability to Afford: These services are very expensive. Cost is the biggest barrier to access. A simple surgery could cost tens or even hundreds of thousands of dollars. Without insurance or significant savings, most people cannot afford it.
Real-World Examples in Hong Kong:
  • Private hospitals like the Hong Kong Sanatorium & Hospital or Gleneagles Hospital Hong Kong.
  • Private clinics run by specialists, GPs, dentists, and physiotherapists.
Quick Look: Pros and Cons

Advantages (Pros):

  • Short Waiting Times: You can often see a specialist or get surgery very quickly.
  • More Choice and Control: You can choose your own doctor, hospital, and appointment time.
  • Comfort and Privacy: Services are often provided in a more comfortable, hotel-like environment with private rooms.

Disadvantages (Cons):

  • Very Expensive: The high cost can be a huge financial burden.
  • Creates Inequality: It can lead to a "two-tier" system where the rich get faster, better care than the poor.
  • Potential for Over-servicing: Because profit is the goal, there is a risk that patients might be encouraged to have tests or treatments that are not strictly necessary.
Key Takeaway

Profit-making health services offer choice, speed, and comfort. They operate like a business, and access is mainly determined by a user's ability to pay.



3. Charity-Based Services: Healthcare with a Heart

This is the non-profit sector, often run by Non-Governmental Organisations (NGOs) or charitable groups.

How does it work?
  • Funding: They are funded through public donations, government grants, and fundraising activities. They do not aim to make a profit. Any money they make is put back into the services they provide.
  • Goal: Their main goal is to serve a specific mission or help a particular group of people. They often fill the gaps that the government and private sectors don't cover.
  • User Groups: They usually target specific vulnerable groups. This could be low-income families, the elderly without family support, people with specific diseases (like cancer or HIV/AIDS), or ethnic minorities.
  • Ability to Afford: Services are typically free or offered at a very low, subsidised cost. The goal is to remove cost as a barrier. To access the service, a user usually needs to meet certain criteria (e.g., have a low income, have a specific illness).
Real-World Examples in Hong Kong:
  • The Tung Wah Group of Hospitals, which operates hospitals and clinics on a charitable basis (though they also receive significant government funding).
  • The Hong Kong Anti-Cancer Society, which provides support and rehabilitation services for cancer patients.
  • Community health centres that provide free health checks or traditional Chinese medicine services for the elderly in a specific district.
Quick Look: Pros and Cons

Advantages (Pros):

  • Targets Specific Needs: Provides specialised help to groups that might otherwise be overlooked.
  • Low or No Cost: Removes financial barriers for the most vulnerable.
  • Community Focused: Often provides compassionate, holistic support beyond just medical treatment.

Disadvantages (Cons):

  • Unstable Funding: Relying on donations can make their future uncertain.
  • Limited Scope and Scale: They may only be able to help a limited number of people or offer a narrow range of services due to resource constraints.
  • May Have Eligibility Rules: Not everyone can access their services.
Key Takeaway

Charity-based services are mission-driven, targeting specific vulnerable groups with free or low-cost care, but they depend on donations and may have limited resources.



Comparing the Three Approaches: A Quick Summary Table

Here’s a simple table to help you remember the key differences. This is great for revision!

Feature
Government Services (Public)
Profit-Making Services (Private)
Charity-Based Services (NGO)
Main Goal Equity & Accessibility (A safety net for all) Profit (A business) Mission-driven (Helping specific groups)
Funding Source Taxes Patients & Private Insurance Donations & Grants
Main User Group Everyone, especially lower-income and elderly Higher-income, those with insurance Specific vulnerable groups (e.g., poor, sick)
Key Advantage Affordability Choice & Speed Targeted & Free/Low-cost
Main Challenge Long waiting times Very high cost Unstable funding, limited resources

Did you know?

In Hong Kong, we have a dual-track healthcare system. This means the public (Government) and private (Profit-Making) sectors exist side-by-side. The public system forms the main safety net, managing over 90% of inpatient hospital care, while the private sector offers an alternative for those who can afford it. Charities play a vital role in filling the gaps!



Final Thoughts: Why Does This Matter?

Understanding these three approaches is crucial because they show how a person's socio-economic status (their income, education, and job) directly impacts their healthcare journey.

A wealthy person can afford to pay for speed and comfort in the private sector. A person with a lower income relies on the affordable public system but may have to endure long waits. And a person facing a specific hardship might find life-saving support from a charity that understands their unique needs.

By learning this, you can better understand health inequalities in our society and think critically about how we can create a fairer system for everyone. You've got this!