The Nanny State Cometh: How government will make you healthy

By Chermaine Lee

Cardiovascular diseases (CVD) are costing Hong Kongers US$4.8 billion, equivalent to half of the government’s healthcare spending in 2018-2019, the Economist Intelligence Unit (EIU) said on Wednesday. Policy options to improve public health and lower the cost are available but have as of yet to be implemented.

In a report presented with biopharma firm Amgen, the EIU said Hong Kong’s prevalence rates of ischemic heart disease (IHD) and stroke are the second highest in the region that comprises China, Japan, Taiwan, South Korea, Australia, Singapore and Thailand.

Out of every 100,000 Hong Kongers, 365 and 314 of them suffered from IHD and stroke, respectively.

Men are more susceptible to CVD than women, and more males died from such diseases. In Hong Kong, ischemic heart disease (IHD) is the third leading cause of death since 1960s, and it killed 11 people daily in 2016.

Economic loss

Leading unhealthy lifestyles has cost Hong Kong a fortune, according to the EIU.

In economic terms, hypertension, smoking, high cholesterol level and obesity altogether have cost Hong Kong around US$3.1 billion annually, which is paid directly to hospitalization, drugs, outpatient care and rehabilitation.

The amount also includes indirect cost such as productivity losses, informal care, and costs due to early mortality and early retirement.

The US$3.1 billion represents 65 percent of the total amount that CVD have cost Hong Kong. This is higher than the average of 62 percent found in the APAC countries.

Silent risks

Meanwhile, the EIU says Hong Kongers might not be aware of the “silent” risks of CVD.

“Hypertension and high cholesterol are ‘silent’, meaning that you don’t necessarily know that these are risk factors unless you go to a doctor and do a test. The long-term effects accumulate over time and by the time they are identified, it can be quite late, so the importance of paying attention to these particular silent risk factors are high,” said Rashmi Dalai, Managing Editor of the Economist.

Smoking is particularly risky for men in CVD, Dalai added.

Policies to remedy: Smoky and sweet

Currently, Hong Kong’s tobacco tax is 67 percent of the retail price, lower than the 70 percent recommended by the World Health Organization. It remains to be seen if cigarettes will be subject to higher tax.

Furthermore, Hong Kong is saying it will strictly regulate e-cigarettes going forward, depriving smokers of a less harmful alternative. Chief Executive Mrs Carrie Lam said in her 2018 Policy Address in October that vaping would be banned in a bid to creating a healthier environment.

The EIU also urged governments to impose “sin taxes” on products high in sugar and unhealthy fats.

Hong Kong’s health department has laid out plans in this regard. It is currently considering a new sugar tax and raising its alcohol duty. For the next seven years, the health regulators aim to tackle CVD among the citizens.

Another suggestion by the EIU is food zoning, which refers to restricting unhealthy facilities around offices and schools.

The EIU also suggests higher investment in green spaces in urban areas and subsidized access to health facilities as lifestyle intervention measures to prevent CVD.