Policy Analysis Critique - Hong Kong Health Care System
Policy Analysis Critique: Hong Kong Health Care System
The health care system in Hong Kong is believed to be one of the best in the world. The majority of people there live longer than people in many other developed nations, and the infant mortality rate is also very low. Those things show that people in Hong Kong are committed to their health and that they have a government that enacts policies to protect them and allow them to have full access to health care. Many countries do not offer that to their citizens, so Hong Kong is actually something of a rarity - and allows its people to enjoy a life expectancy of upwards of 80 years for both men and women. That is the second-longest life expectancy of any country in the world. Of course, there are imperfections in the health care in Hong Kong, just as there are anywhere else. People who live there still pass away, and some of them still die from diseases that are preventable or that went untreated or improperly diagnosed. Such is the nature of medicine.
Addressed here will be one specific policy in the Hong Kong health care system, so that the policy can be examined in-depth. Addressing too many policies or too many issues all at once does little for any study, because there is only space to touch the surface. When considering just one policy, there is room to examine the creation of that policy, why it was needed, what it offers, and what it lacks. No policy for health care in any country has everything that is needed. There is always something that could be done to improve it. However, every health care policy has value because if offers something to the people who are subject to that policy. Considering both sides of the equation can seriously help any country that is working on making health care policies, because each country is both similar and different when compared to other countries. The "dos" and "don'ts" of policy creation can be more easily seen in comparison.
For purposes of this particular paper, the Hong Kong health care policy addressed has to do with exercise. This is one of the most significant imperatives for public health in Hong Kong, and really came about because of what was being seen in other countries. Many people in their later years become incapacitated or develop avoidable diseases because of the lack of exercise they had in their early and middle-aged years. There are many chronic (and generally avoidable) diseases that are brought on by a lack of physical activity. Cardiovascular disease, obesity, diabetes, and other problems can occur in people who are too sedentary and who do not move around enough to maintain good health. One of the leading causes of death in Hong Kong is cardiovascular disease, and one of the goals of health care in that country is to reduce the number of people who are struggling with that problem and who develop cardiovascular problems every year (Adab & Macfarlane, 1998).
When people regularly participate in moderate amounts of exercise, those people live longer, healthier lives, on average (American, 1975; Berlin & Colditz, 1998). However, many of the people in Hong Kong still do not realize the significance of a high level of exercise - and that is particularly apparent with programs that are geared toward children. Almost 60% of the people in Hong Kong are relatively sedentary, and only a third of people there exercise enough to see serious health benefits from it. The children in primary school in Hong Kong are, most likely, the most inactive of any in the world. Because that can provide a high level of risk, schoolchildren needed to be made a priority when it comes to programs that will get them up and moving. In addition, they and their parents need to be made to understand that there are consequences for sedentary behavior and that there are ways in which the problems that can result from it can be mitigated. The policy issue, therefore, focuses more on children and less on adults.
This particular policy, which addresses the need for exercise programs for children, came about because it was seen how sedentary the Hong Kong lifestyle is for primary schoolchildren. Naturally, that is a concern. When children are very sedentary, they can start the development of diseases that are typically seen in people that are much older. Diabetes, heart disease, and other problems can begin to develop, and as these children age they will begin to get sick much earlier than their parents did (Powell & Blair, 1994; Shephard, 1994). Adults should exercise, too, of course, but it is vital that children move around and that they focus on good habits that they can develop from a young age. Many of those habits can be taught at home, by seeing what their parents do, but learning at school is also valuable (Wong & Macfarlane, 1997).
For primary schoolchildren in Hong Kong, being sedentary is just something that they are used to and to which they adapt because they do not know any other way. They see no need to move more, because they have not been taught about all of the benefits that they can (and should) get when they are more active. Once they realize the value of exercise, they will be more likely to engage in it more frequently (Adab & Macfarlane, 1998). Their parents must learn about the importance of exercise, as well, because any person who exercises is going to be healthier than a person who does not exercise. When parents do not exercise, it is much harder to teach children to do so - and it is also much harder to convince children that they should do something that their parents are not doing, because that often does not make sense to them.
Having a policy in place offers an opportunity to focus on the benefits of exercise, instead of ignoring the issue. In other words, not having a policy means that it is much easier to assume that exercise is not necessary. When the government gets involved and starts saying that it is done research into an issue of importance to the public, recommendations can then be made as to how that research should be handled (Adab & Macfarlane, 1998). That was the case in Hong Kong, where the government studies information that can help its citizens and then provides that information and sets policies based on it. Of course, no one can be forced to exercise. However, health care policies can be established that would help encourage exercise and that would make it more common and more likely. One such policy along those lines involves the amount of exercise that primary schoolchildren get in Hong Kong (Adab & Macfarlane, 1998).
There are many benefits to exercise, especially in children. It helps to decrease body fat, increase cardiac output, and keep the entire body healthy Paffenbarger & Lee, 1996; Taylor, 1996). Starting young makes a significant difference, but a person can start exercising at any age. While the people of Hong Kong have nearly the best health care in the world, that is only used to help prevent disease and to treat it when it comes about. Another way that disease could be prevented would be through the encouragement of undertaking measures designed to ensure good health - like exercise. Clearly, the Hong Kong government would need to get more involved with the issue, because policies need to be set for primary schoolchildren and how much exercise they should be getting each day. Right now, they basically get little to no exercise.
As can be seen in Table 1, there are a large number of benefits to be enjoyed when a person starts exercising, and those benefits can last for a lifetime as long as the person stays active.
Source: Coronary heart disease: The benefits of exercise. (2010). Australian Family Physician, 39.
Showing a table like the one above to children is not going to convince them to exercise, however, because they are not interested in those kinds of statistics. There are two things that the Hong Kong government will want to consider when addressing its health care policy and the amount of exercise children are getting: how to make the experience of exercise enjoyable, and how to educate both children and parents in a way that makes sense and that they can more easily understand. Without both of those issues at play, it is very unlikely that parents and children are going to truly get involved with exercise and make it a habit which will be lifelong and provide all of the necessary benefits.
The following chart shows that deaths from chronic diseases are not limited to low income and lower middle income countries. These diseases are taking place in upper middle income and high income countries, as well.…