A Study On Take Home Examination Social Policy

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Besides, Dean outlined two conceptual frameworks for welfare rights, including doctrinal concept and claims-based concept. Doctrinal concept 'ensured equal opportunity through the redistribution of opportunities, rather than outcomes'. Claims-based concept 'demanded not merely formal equality of status, but the actual redistribution of resources'.

Moreover, Dwyer (2004) pointed out there are four principles underpinning welfare rights, including universalism, selectivism, contributory/social insurance principle and conditionality. A universal principle of welfare services provide to all citizens on an equal basis. Every citizen enjoys access to the same set of social rights. Welfare services based on selectivism are limited to certain specified individuals or groups usually by the application of a means test. Contributory/social insurance principle usually entails employees having National Insurance (NI) contributions deducted from their earnings in the paid labour market (PLM). Conditionality is dependent on an individual first agreeing to meet particular compulsory duties or patterns of behaviour.

The Extent and the Ways of Medical Service in Hong Kong is a Welfare Rights

According to the Hospital Authority (2008), the policy of medical service in Hong Kong is that 'no one will be denied adequate medical care due to lack of means'. This policy practices the concept of welfare rights that everyone has the equal opportunity to have the medical service even the one who lives in poverty.

Universalism Principle

Under the universalism principle, all citizens can get the Ambulance Services (2003) on the equal basis, including Emergency Ambulance Service (EAS) and Non-Emergency Ambulance Transfer Service (NEATS). ESA is 'provided for persons whose conditions require immediate pre-hospital treatment and transfer to a hospital for prompt medical attention'. The NEATS is 'provided for patients who require transport service to / from medical institution'.

Besides, all citizens can go to the local public hospitals and institutions and get the medical service on the equal basis, including Accident & Emergency (A&E) Services, Specialist Clinics, In-patient and Out-patient Services.

However, citizens need to pay for those services. The A&E Services, Specialist Clinics and the In-patient Services cost $100 per time, and the Out-patient Services cost $45 per time.

The A&E Services need to be charged because the Government hopes people will not misuse the services. However, the poor patients who are not the Comprehensive Social Security Assistance (CSSA) recipients may be excluded. Although the CSSA recipients can be remitted the charge, it is unfair for the poor patients who are not CSSA recipients and have the emergency illnesses, especially the elders who rely on their own saving only.

Besides, the Government launched the Elderly Health Care Voucher Pilot Scheme (HCVS) (2008) in the 2008-09 financial year for three years to provide 'five health care vouchers of $50 each to elders aged 70 or above annually to partially subsidise their use of private primary healthcare (PHC) services'.

Selectivism Principle

Under the selectivism principle, because of the medical fee waiving mechanism, CSSA recipients and the vulnerable groups are waived from payment of public health care expenses when they meet certain financial and social criteria.

Also, there are three types of people who are not CSSA recipients, also can waive from payment of public health care expenses, including low-income group, the elderly patients with little income or assets and people with chronic illnesses.

Contributory/Social Insurance Principle

Under the contributory/social insurance principle, in the Consultation Document on Healthcare Reform (2008), the Government suggests six different proposals to provide supplementary financing for healthcare, including social health insurance, out-of-pocket payments (user fees), medical savings accounts, voluntary private health insurance, mandatory private health insurance and personal healthcare reserve.

Although there is no mainstream consensus has yet been reached in the community on the introduction of supplementary financing and the option to be adopted, the Government can analyze the pros and cons of the six different proposals, especially the social values they represent, including the equity of access to healthcare, pooling and sharing of healthcare risk, re-distribution of wealth and financial stability and sustainability in order to protect all citizens' well-being.

Conditionality Principle

Under the conditionality principle, there is the Samaritan Fund managed by the Hospital Authority in order to provide financial assistance to needy patients who requires designated Privately Purchase Medical Items or new technologies in the course of medical treatment which are not covered in hospital maintenance or out-patient consultation fees in public hospitals and clinics.


The report of Strategic Service Plan 2009-2012 from the Hospital Authority (2009) named 'Helping People Stay Healthy'. It shows that the total population of Hong Kong will increase from 7 million to around 7.5 million in 2016. Currently at around 870,000 and representing 12.6% of the population, people aged 65 and above will increase by 30% to 1.13 million in 2016. Besides, people are living longer than ever. Our life expectancies will further increase to 86.3 and 80.6 years respectively in 2016. Therefore, it is recognized that people require more healthcare services in old age. For example, the Government will improve community care for elderly and chronically ill patients and empower patients on self-care. I hope that the Government can continue providing the universal medical services and the equitable system that payments are pegged with affordability and all residents have equal opportunities to medical services. Also, the Government should ensure patients' right of choice in public and private medical services. Besides, the residents' well-being should be alerted when starting the Healthcare Reform in the future. Social health insurance is to ensure that every resident can obtain appropriate medical services as its coverage is universal and the medical expenditure is paid by contributions from all, including the healthy and the sick, the wealthy and the poor in order to share health risks.

Question 4:The Concept of Welfare Mix

Powell (2007) stated the mixed economy of welfare (MEW) or welfare pluralism (WP) is a vital, but relatively, part of social policy. In the descriptive sense, Beresford and Croft (1983) pointed out that there are four components of MEW. The prescriptive sense suggested a change to the mix such as 'rolling back the state'. Besides, Rose and Shiratori (1986) argued that 'total welfare' is the sum of state, market, voluntary and informal sources. Moreover, Mishra (1990, pp. 110-114) claimed that a focus on 'total welfare' is not simply the 'sum of parts'. The components 'cannot simply be regarded as functionally equivalents' (p. 110).

Powell pointed out the prescriptive use of MEW showed that different welfare ideologies favour different welfare mixes. The political left affected the role of the state becomes larger in welfare as only the state can ensure that welfare benefits and services are fairly distributed to all citizens. If there were a large role for the commercial, voluntary and informal sectors, inequality would be appeared.

In a descriptive sense, according to Lewis (1995, p. 3), it is more accurate to see Britain as always having had a mixed economy of welfare, in which the voluntary sector, the family and the market have played different parts at different times.

On the other hand, Richard Titmuss developed the social division of welfare in a lecture in 1956. After that, Titmuss (1958) pointed out that welfare was delivered by fiscal and occupational mechanisms in addition to the more familiar 'social services'. First, statutory welfare refers to publicly provided goods and services. Second, occupational welfare is related to people's occupations and also termed fringe benefits or corporate welfare. Third, fiscal welfare refers to costs or benefits delivered through the taxation system.

Applying the Concept of Welfare Mix in the Retirement Protection in Hong Kong

In the State Welfare, The Mandatory Provident Fund Schemes Authority (MPFA) (2006) pointed out that Hong Kong has a rapidly ageing population. In 2004, the proportion of the population over the age of 65 was around 12%, but by 2033 this is projected to rise to 27%. The number of working age adults for each person over 65 will drop from around six now to close to two by 2033. This means the working population will have a larger number of retirees to support in the future.

Starting from the 1960s, the debate for a suitable retirement protection system in Hong Kong has gone on. Three different systems, including privately managed provident funds, a central provident fund and a pay-as-you-go type of benefit system were proposed. In 1994, the World Bank published the report 'Averting the Old-Age Crisis: Policies to Protect the Old and Promote Growth', in which a three-pillar approach to protection for the aged was put forward. The three pillars included a publicly managed, tax-financed social safety net; a mandatory, privately managed, fully funded contribution scheme and voluntary personal savings and insurance. The MPF System in Hong Kong was designed to form the second pillar of this approach for retirement protection. The Mandatory Provident Fund Schemes Ordinance (MPFSO) was enacted in 1995 and the MPF System was launched in December 2000. For both employees and employers will also be required to contribute 5% of the employees' relevant income to the MPF scheme.

The MPF scheme was designed by the Government (State Welfare) who has the high regulation that the MPFA applies a number of enforcement measures against non-compliant employers who are found to have evaded payment of MPF contributions, deducted employer contributions from an employee's pay or not enrolled their employees in any MPF schemes. At the same time, different banks or insurance companies (Market Welfare) take the role of provision that helps the employees to decide on their own investment portfolios.

However, there are some limitations of the MPF scheme. First, the domestic employees, self-employed hawkers, housewives and other people who are not in the labor market cannot join the MPF scheme in order to get the retirement protection.

Second, there is the direct proportion between the retirement protection and the income from the employees, so the redistribution of welfare cannot be appeared and the low-income people's retirement protection will be damaged.

Third, the employers can offset severance payment ("SP") and long service payment ("LSP")as required under the Employment Ordinance ("EO") by the accrued benefits derived from contributions you have made to the employee in the MPF scheme, so the employees who are in job insecurity cannot get the enough retirement protection.

Because of the limitations of the MPF scheme, citizens need to protect personal livelihood of retirement through other methods. For example, people can get the Comprehensive Social Security Assistance (CSSA) provided by the Social Welfare Department (SWD) under the State Welfare, products of retirement planning provided by banks or insurance companies under the Market Welfare, the emergency relief fund, chronic illnesses relief fund or food bank operated by the non-governmental organizations (NGOs) under the voluntary welfare and family support or personal saving under the informal welfare.

Conclusion and Suggestion

Under the Policy Address in 1997, 'A Sense of Security, A Sense of Belonging and A Feeling of Worthiness for the Elderly' is the main policy of elderly care. However, it seems that the MPF scheme and other retirement protections cannot totally reach the policy of 'A Sense of Security'. The Joint Alliance for Universal Retirement Protection (2004) is an alliance that aims to fight for the universal retirement protection. I agree with the principles of the alliance in which every elderly should have the human rights (e.g. the right to life, housing right and medical right) and be prevented poverty. At the same time, the current protection of all social class of the elderly provided by the Government will not be damaged even starting the new retirement protection. I hope that there will have the universal retirement protection in the future in order to protect all citizens' well-being when facing the aging of population in Hong Kong.

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