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Financial Secretary Orders Medical Spending Cuts Amidst Budget Shortfall

Flaw in medical proposal for HK emigrants

Financial Secretary Paul Chan Mo-po has directed policy bureaus to develop plans to curtail spending in response to a budget shortfall of over HK$100 billion and a bleak economic outlook for the coming year. However, a proposal that has garnered significant attention in recent days may prove to be flawed despite its initial appeal.

The proposal suggests that Hong Kong residents who have emigrated for an extended period should no longer be entitled to use local public medical services upon their return, instead being charged fees akin to those imposed on foreigners. The idea has found support from various quarters, including medical sector lawmaker David Lam Tzit-yuen, who believes that a review may be necessary to differentiate between emigrants and local residents.

While the proposal is still in its early stages, it is important to consider its potential impact if it were to become policy. Contrary to popular belief, it is not recent emigrants who would be most affected, but rather those who left Hong Kong several decades ago and are now retired. This group represents the earliest waves of emigration and has the most apparent and immediate medical needs.

The estimate provided by lawmaker Kitson Yang Wing-kit, suggesting that around 200,000 Hong Kong residents have permanently left the city, may be an underestimation if it does not account for those who emigrated in the 1970s and 1980s. Many of these early emigrants were primarily villagers with strong ties to local clans in the New Territories and have maintained strong connections with their clans or representatives in the Heung Yee Kuk.

Despite having resided overseas for many years, these individuals have a deep sense of patriotism and identify themselves with Beijing, in contrast to many who have left Hong Kong since 2019 under the British National Overseas (BNO) or other visas. It should be noted that the proposal may have repercussions for the later group as well, especially elderly individuals who have limited English proficiency and rely on Hong Kong’s public health services for scheduled medical appointments.

If these emigrants were treated like foreigners upon their return to Hong Kong for medical consultations, it would not be surprising if many decided to permanently return due to concerns about their health. However, this is unlikely to hold true for younger emigrants who have already acclimated themselves to different cultures and lifestyles. These individuals rarely utilize Hong Kong’s medical services, as they are fluent English speakers and can navigate their local health systems effectively.

Given these considerations, it is doubtful that implementing the proposal would result in significant cost savings for the government. Those who are already dependent on Hong Kong’s public health system are likely to return for good and avail themselves of other social benefits, such as public housing and allowances for the elderly. The potential financial impact of this policy must be carefully evaluated against its potential consequences and unintended outcomes.

As discussions around this proposal continue, it is crucial for policymakers to consider the long-term implications and seek a balanced approach that addresses budgetary concerns without compromising the welfare of Hong Kong residents, particularly the elderly and vulnerable populations who have contributed to the city’s development over many years. (Isabel Almonte)