Promoting collaboration in regional healthcare systems in Hong Kong, Macao, and the mainland of China: midrange strategies

The collaboration of healthcare systems in Hong Kong, Macao, and the mainland of China is a critical issue for addressing the medical needs of internal migrants in China, who often face disparities in coverage and access to services when moving across these three regions. These migrants are particularly disadvantaged by the structural differences between the universal public healthcare systems of Hong Kong and Macao and the combined social medical insurance and universal health insurance system in the mainland of China. This paper examines these distinct healthcare models and finds that significant differences in coverage, funding, and service delivery pose key challenges to the portability of benefits for cross-region migrants and the collaboration of regional healthcare systems. To advance healthcare collaboration and ensure that migrant populations receive equitable healthcare, the paper proposes establishing a fiscal compensation mechanism to address the financial imbalances caused by cross-region service usage. It also advocates for adopting principles for the portability of healthcare benefits and regulating cross-region medical services to create a more cohesive and integrated regional healthcare system.