Dr-HMO is the problem!

We would like to present our logic here - the establishment of doctors' HMO is NOT A VIABLE solution. It will make things worse. The damage done by doctors' HMO will span across the whole profession, with only a few small group of doctors getting the benefit. 

1. If the doctors' HMO recruits only 1-2 thousands of GP, half of the professional will be severely jeopardized by not joining the HMO. The doctors-HMO means that all GP should practice the cheap medicine, i.e. to treat as many patients as possible regardless of the quality, since it is the volume of your patients that counts. What happens to those GP who would like to see fewer patients, practicing better quality but higher charge medicine? 

2 The rationale of doctors' HMO is to take back the market share of the commercial HMO, or even crowd out the commercial HMO. This is naive to think that the commercial HMOs will quit the market on facing the challenge. They will fight back by lowering the price. The end result is simple - there will be a price war in the HMO business. Of course, this is very much welcomed by the Government and the public. But do we really want to start a cut-throat price war in our profession? We can be sure that the total market share of the HMO will rise like a rocket, and that means our income will drop like a stone, when more and more people switch over to the HMO for the cheaper medicine. 

3. The biggest concern, therefore, is the total market share of HMO. As mentioned in the HKMA News, there is a large difference in the market share of the HMO in various parts of USA due to the different regulations imposed on the HMO. The problem here is - if the doctors' HMO is very successful, more and more companies and people will join in. We cannot reject the new comers and just focus on taking over the existing commercial HMO contracts only. The end result is simple - more and more people will join the doctors' HMO and enjoy the cheaper medicine. The total market share of HMO grows rapidly, and our income dwindles drastically. Are we willing to suffer just to make sure that the commercial HMO will die as well? 

Therefore, we would say that the doctors' HMO is not a viable solution. It can and surely will make things worse. And the problem it brings out is the practice of cheap medicine in our whole profession. It will end up with fewer and fewer CASH patients while gaining more and more contract patients. We are sure that the Government or the public wish to see this scenario and even push ourselves towards the USA system i.e. all HMO cover, and no more cash patients, so as to further squeeze on the private doctors' charge. Remember that the Harvard report's blaming us on our overcharged private sector? 

In other words, we think regulating the HMO is the ONLY available solution we have. Our goal is to LIMIT the HMO market share, to stop their overcharge of the HMO administration fee. We do not have a data on the existing HMO market share, but our rough guesstimation is around 10-20 %, with the remaining more than 80% being cash patients. We should preserve this ratio, and if possible, to increase the cash patients' market share. 

That comes the second principle: we cannot be both the JUDGE as well as the PLAYER. It sounds unfair to anyone, esp. in the eyes of the public and the Government, when the doctors push for the regulation of the HMO on one hand, while on the other hand, participate in the HMO market to make the most profit out of it. Any regulations pushed or proposed will be of the lowest credibility, and no public support will be on our side in fighting against the HMO. It is the public support and the Government’s support that we need in the war against the HMO, not just the minute profit from running the HMO, right?

A group of private doctors