【明報專訊】CHARGE DISPUTES often arise with private healthcare facilities. The latest study conducted by the Consumer Council has revealed that the price information provided by many private healthcare facilities is confusing and insufficient, while pricing discrepancies may be huge. The overall resolution rate of complaint cases intervened by the Council was only 35%, highlighting inadequate consumer protection.
The fact that patients lack professional medical knowledge and can only rely on doctors' advice leads to information asymmetry. Every now and then, patients do not recognise that their bills have exceeded the budget estimates until after examination or even treatment. As the government plans to increase price transparency in private medical services through legislation to reduce disputes and enhance consumer protection, the recommendations given by the Consumer Council are worthy of reference.
There are four types of private healthcare facilities in Hong Kong, namely private hospitals, day procedure centres, clinics, and health services establishments. The Private Healthcare Facilities Ordinance gazetted in 2018 stipulates a list of price transparency measures that private hospitals and day procedure centres have to implement, yet, charge disputes still happen from time to time.
From 2021 to 2024, of the 191 complaint cases the Consumer Council received concerning private hospitals and day procedure centres, more than 45% were price disputes. The Council said that despite the price transparency measures stipulated in the Ordinance, the practices of different healthcare facilities were inconsistent, and the market lacked a set of rules for disclosing price information.
Under the Ordinance, private hospitals must provide price information and budget estimates, as well as historical statistics on charges. However, the Consumer Council's report finds that the price information provided by many private hospitals was difficult to understand and inadequate, the historical charge statistics were not updated, and the fee for the same treatments could vary substantially between patients. For instance, the median charge for inpatient haemorrhoidectomy ranged from $30,000 to $85,000, which is more than double.
Of the consumers (patients) responding to the Council's questionnaire, nearly 40% received only verbal budget estimates. Two-thirds had been puzzled by the price discrepancies without receiving any explanation. Moreover, 90% of the respondents were even unaware that they could access the historical charge statistics. This clearly reflects the serious asymmetry of information between operators and patients.
The report points out that the charging mechanism of private hospitals and day procedure centres has been ambiguous. Doctor's fees were generally excluded from the fee schedule, and the basis for setting the fees was seldom disclosed. Most of the sampled day procedure centres also failed to provide online price lists for the selected treatments.
Except for caesarean section, colonoscopy and gastroscopy, healthcare facilities in Hong Kong seldom provide medical packages. Even those available might not be "all-inclusive", patients often find that some treatments or medications are not included and require additional payment.
The Consumer Council has put forward several recommendations in its report, including offering price lists online, promoting the adoption of medical packages, enhancing the regulatory framework, and clarifying the responsibility of explaining the pricing of charged items. These suggestions are worthy of reference by the authorities for enacting relevant laws. In the long term, the authorities should strive to set up a central database to facilitate fee comparison for the public.
明報社評2025.03.07：私營醫療收費爭拗多 早日立法提高透明度
私營醫療機構收費不時引發爭議，消委會最新研究指出，不少私營醫療機構價目資料難明及不足，收費差距可以很大，消委會介入的投訴個案，整體調停成功率僅得三成半，突顯消費者保障不足。
病人缺乏相關專業知識，只能依賴醫生判斷，醫患之間資訊不對稱，病人接受檢查甚至治療後才發現收費超出預期，更是時有發生。政府擬立法提高私營醫療收費透明度，減少爭拗，加強保障消費者，消委會的建議值得參考。
在香港，私營醫療機構可分為4類，包括私家醫院、日間醫療中心、診所及衛生服務機構。2018年，《私營醫療機構條例》（下稱《條例》）刊憲，列明私院及日間醫療中心所要採取的收費透明度措施，只是有關收費的投訴，仍然不時出現。
2021至24年間，消委會共接獲191宗有關私家醫院及日間醫療中心的投訴，當中逾四成半與收費爭議有關。消委會提到，《條例》雖有列明收費透明度措施，但不同醫療機構做法並不一致，市場亦缺乏一套披露價目資料的準則。
根據《條例》，私院須提供價目資料、收費預算、過往收費統計數據，惟報告發現不少私院價目資料難明兼不足，收費統計數據沒有即時更新；相同的治療，不同病人收費可以有很大出入，以住院切除痔瘡手術為例，中位數收費由3萬多到8.5萬元不等，價格相差一倍有多。
根據消委會的問卷調查，受訪消費者（病人）中，近四成只獲口頭告知服務費用預算，2/3受訪者曾遇價格差異疑惑，但大多得不到任何解釋，更有九成受訪者說不知道可查閱過往收費統計數據。醫患資訊嚴重不對稱，在此可見一斑。
報告指私院及日間醫療中心收費機制含糊，收費表一般不會列出醫生費，亦絕少向消費者披露醫生的定價標準；抽樣調查的日間醫療中心，大多沒有就指定治療在網上提供收費表。
除了剖腹分娩、大腸鏡及胃鏡檢查套餐，本港醫療機構較少推出醫療套餐，就算有都不等於「全包」，病人每每事後才發現，部分療程和藥物並未包含其中，需要另行繳費。
消委會報告提出多項改善建議，諸如網上公布價目表、鼓勵多推醫療套餐，以及加強監管框架，釐清解釋價目資料責任等，值得當局立法時參考。長遠而言，當局更應爭取設立中央資料庫，方便市民比較收費。
■ Glossary 生字 /
asymmetry : the situation of not being equal or the same
gazette : announce or publish (sth) in an official gazette
ambiguous : that can be understood in more than one way; having different meanings