MR CHAN KIN-POR (in Cantonese): President, the background to this incident is actually attributed to the significant departure in recent years of “non-medically necessary” hospital confinement and some claims from the normal standard. As in the examples cited by the insurance company, the claims for cholecystectomy, which costs between $50,000 and $80,000, and colonoscopy, which costs $10,000 or so, amount to $40,000 and $170,000 respectively. Such a situation, if remains not checked, will only lead to steep premium hikes which will go beyond the affordability of the public. Now, the insurance company merely wishes to communicate with doctors and reiterate the “medically necessary” term which has existed for many years. I hope Members can understand that the purpose of the insurance company in communicating with doctors is to work out a solution to a major crisis, with a view to protecting consumers in Hong Kong. We should absolutely not look at this matter in a negative light. This supplementary question of mine should actually be directed to Secretary Dr KO Wing-man, but he is not present at the moment. Is Secretary Prof K C CHAN aware that the discussion between the insurance company and the doctors was actually conducted among doctors, not non-professionals? Instead, it was conducted between two professionals. If the doctor concerned can convince the insurance company that the situation of the person concerned was so special that hospital confinement is necessary, then he will receive full compensation. Is the Government aware of this? I hope the Secretary can give me a reply.
SECRETARY FOR FINANCIAL SERVICES AND THE TREASURY (in Cantonese): We certainly appreciate the situation mentioned by the Honourable Member. Insofar as I am aware, the “medically necessary” concept is also a standard that has been observed by the industry for many years. Moreover, according to the usual practice, the attending doctor should make a judgment on whether a procedure is “medically necessary”. Should the insurance company consider it necessary for the relevant party to furnish an explanation, the doctor concerned will be required to provide reasonable and detailed information for confirmation of whether or not the relevant case is “medically necessary” and covered by the policy.