Editorial
Time to reconsider health insurance proposal
It is all very well to have a state-of-the-art general hospital, as we now have, and to aim at having a first-class service to cater for all medical needs, and to have available the best and latest drug treatment on the market. The problem is how to finance the running of the hospital and the other health services run by the state. Add to this the financing of the other social services and the problem multiplies. It particularly projects itself into sharper focus at times of economic difficulties or of a situation where the government has to step in, as it is doing now, to stimulate the economy as the recessionary trends in Europe and elsewhere start having an effect on the economy.
When Queen Elizabeth recently visited the London School of Economics, one of the first questions she put after academics explained to her the origins and effects of the credit crisis was: "Why did nobody notice it?" It was, of course, the question millions of people around the world had asked as they learned of the impact of the credit crunch on the economies of their countries.
It can hardly be said that Malta has not noticed the ballooning cost of keeping the island's health services but it looks as if the country is closing one eye to it. Social Policy Minister John Dalli is therefore right to keep raising the issue. Ideally, he should now take a step further and press for action but, in today's difficult circumstances, it may be best to keep preparing the way, as it were, without losing his determination to ensure the sustainability of the health services within a reasonable timeframe.
Speaking at a seminar on the sustainability of the social services organised by the General Workers' Union, Mr Dalli remarked that in the budget for next year the government was projecting to spend €1.25 billion on health services, a staggering amount by any account. The figure is not likely to have made much impact on the public, not when, in the wake of the presentation of the budget, politicians from both sides of Parliament have been dishing out figures on all matters under the sun, almost literally, if one were to take into consideration the discussion on costs and rebates on energy-saving devices.
Few ever reflect on the costs involved in running health care and many hardly think twice of wasting precious resources, as shown by the well-known fact that there are people who abuse their entitlement to free medicine by continuing to take their entitlement even when they no longer need it. Little do they realise that their "free" medicine is financed out of taxes. Quite justifiably, Mr Dalli is promoting a debate on the possible introduction of public health insurance, financed out of a fund partly built up out of social security contributions.
But had not the government something similar in mind when it raised the value added tax from 15 per cent 18 per cent five years ago? Yes, but the idea had never really taken off. In the light of the public's growing expectations, greatly reinforced by a recent court decision over entitlement to payment for a particular case of surgery that could not be carried out in Malta, it is becoming even more necessary to go into the whole issue of ensuring, with the full backing of the opposition in Parliament, the sustainability of the health care service.
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E. Azzopardi
Dec 3rd 2008, 19:30
And why aren't those already privately insured exempted from tax on the amount they pay on their insurance? This was promised in 1998 but as other cases this promised was not kept, eight years later!!!!!!
lgalea
Dec 3rd 2008, 18:18
David Meilak
You are wrong.
Most, if not all other eu countries do not have free health service or it is very limited.
So this is not another benefit but a negative effect of eu membership.
albert spiteri
Dec 3rd 2008, 16:26
To base the argument for privatization healthcare on the Queen's "Why did nobody notice it?" is a dishonest leg-pull.
The credit crisis is a natural result of the evils of global capitalistic strategies and policies. .
The Queen's question was immediately answered by Professor Garicano informing Her Majesty that the credit crisis was foreseen by many who did warn about what was most certainly about to happen to the USA the world economies. Garicano said: Paul Krugman, this year's Nobel prize winner in economics, has argued for years that a housing bubble was replacing the internet bubble, and in 2005 Paul Volcker, Alan Greenspan's predecessor as chairman of the US Federal Reserve, wrote that "we are buying a lot of housing at rising prices, but home ownership has become a vehicle for borrowing as much as a source of financial security ... On the present trajectory, the deficits and imbalances will increase."
Government selling off of profitable strategic entities is to blame for governments inability to finance a comprehensive social policy, including healthcare.
If governments, like ours, go ignoring their social obligations, bankers and corporate CEO's take over. The results speak volumes!
Unbridled capitalism is now as dead as communism.
Leo Said
Dec 3rd 2008, 12:05
"In the light of the public's growing expectations, greatly reinforced by a recent court decision over entitlement to payment for a particular case of surgery that could not be carried out in Malta, it is becoming even more necessary to go into the whole issue of ensuring, with the full backing of the opposition in Parliament, the sustainability of the health care service".
The case, to which the editorial refers, is, or may yet be, a precedent for practices in Malta.
As an addendum, actually falling into the same context, allow me to raise the diabolical and hairy question whether patients, who suffer from any form of intracranial pathology, will now have a right to request treatment at the National Hospital in London.
Leo Said
Dec 3rd 2008, 11:57
Health Services expenditure is a big contemporary problem, for example, even in Germany, where 15.5% of one's income, exclusively for one's health insurance, do not seem to be enough to finance a system, in which:
1. patients may choose their gate-keeper doctor,
2. doctors, paramedics and nurses are reimbursed in a satisfactory and appropriate way,
3. hospitals are kept to professional standards and
4. patients receive the respective treatment, which they may need.
In addition to the 15.5% of one's income towards health insurance, there come the premium for the respective pension schemes, the premium for unemployment benefits and of course the income tax.
If I am informed correctly, MDH can request payment from the medical insurance covers of EU citizens, who receive treatment at MDH. Brussels has provided specific regulations on this issue.
David Meilak
Dec 3rd 2008, 10:27
I. Galea, your comments make sense until you scew towards political bias and the fact like many of us Maltese tend to regard our islands as the worlds' umbilicus. As you mention correctly that Mater Dei or any other health facility on our island is open to other EU citizens alike...........have you ever thought of the fact that there are other EU countries that reciprocate the same deal towards Maltese nationals that may have to make use of Health facilities in one of the other EU countries.
This is another benefit of joining the EU.
lgalea
Dec 3rd 2008, 09:45
We pay our taxes to receive medical treatment and other services.
VAT was specifically increased from 15% to 18% specifically, according to the Gonzipn, to cater for the Mater Dejn facilities.
The Government should tell the people the truth that since Maltese citizens have free treatment, citizens from other eu member countries must be given the same treatment free because if not they would raise the issue of discrimination.
Thus the Mater Dejn facilities cannot discriminate between Maltese citizens who have paid taxes all their lives and get free treatment and other eu members citizens who have not paid one single euro cent in tax to the Maltese Government.
This is the reason why the Government wants to introduce an insurance scheme because the service will be unsustainable if citizens from other eu member countries come to Malta and end up in Mater Dejn either accidentally or purposely.
This is another negative effect of eu membership.