Hong Kong health costs outpace GDP as prevention remains underfunded

Poor diets undertreated patients and underpaid public health workers are pushing Hong Kong costs beyond GDP growth.

Hong Kong should put more healthcare spending into primary prevention as ageing, costly drugs and medical innovation push health costs above economic growth.

Speaking in an interview during the Asian Global Health Summit, David Bishai, Clinical Professor at the School of Public Health at The University of Hong Kong, said public health remains the most cost-effective way to reduce future disease burden. “The public health profession has always been the best buy,” Bishai said.

Hong Kong’s estimated health expenditure accounts for around 18.2% of the government’s budget, but Bishai said spending is growing faster than GDP. He said ageing is only part of the pressure, with expensive new drugs and treatment intensity also driving costs.

“The only way for Hong Kong to try to bend the cost curve so it doesn't grow faster than the GDP is primary prevention of disease,” he said.

Diet and nutrition should be a priority. Bishai said Hong Kong performs well on low tobacco use, low alcohol intake and high physical activity, but less than 5% of residents get five fresh fruits and vegetables a day. Improving diets could help reduce diabetes, hypertension, heart disease, atherosclerosis and cancer risks.

The healthcare sector also needs to stop relying only on short clinic visits to change behaviour. Bishai said a typical outpatient visit lasts five minutes, leaving little time for lifestyle counselling. He pointed to link workers or social prescribers as a way to connect patients with NGOs, community groups and nutrition support after consultations.

Public health workforce investment is also needed. Bishai said mainland Chinese applications to public health programmes are rising, whilst local Hong Kong interest has returned closer to pre-COVID levels. He said compensation for public health roles has not kept pace with clinical jobs.

Hospitals should also invest in population health units to support patients after discharge. “We cannot afford to let patients leave and get sick again,” Bishai said.