The interview with Joe Caruana, former Mater Dei CEO (The Sunday Times of Malta, August 23), on the sustainability of free healthcare essentially reiterates what governors of the Central Bank (and in particular Michael Bonello) have repeatedly stressed, namely that the health and education systems are not financially sustainable in the long term.
As the article explained, health systems around the world are under considerable financial stress because most new pharmaceutical drugs are very expensive. Our welfare State needs a complete re-think but all major political parties regard such a re-think as political suicide.
The re-think must be radical and needs study of alternatives to our copying blindly the British NHS. Health analysts in the UK have just predicted that the explosion of diabetes type 2 rates alone (mainly caused by overconsumption of sugars and starches) will bankrupt their NHS in the foreseeable future.
Some other health systems in Europe, and perhaps in Australia and New Zealand, need to be examined. Building new hospitals and an inability to afford new drugs is not modern medicine – it’s just a goldmine for the construction industry.
We have practically no means-testing (except in old people’s homes) in the health and education systems. Our whole welfare edifice actually favours the rich over the less well-off. Free health and tertiary education with stipends is open to all, including the rich.
The Mater Dei project needed an increase of VAT from 15 per cent to 18 per cent, which hit mainly the poor, while the rich don’t even need to suffer some annual property value tax, as they do in all other major mature organised countries.
To add insult to injury, and in particular to some of our poor, thousands of pensioners have their mandatory contributory Social Security pension reduced simply because they have another occupational pension. This institutionalised pension fraud, together with removal of pension contributions’ ring-fencing in 1979, means that workers’ pension contributions have been used to partly fund other welfare sectors, such as non-means-tested health and tertiary education with stipends.
This means that taxation of some of our poor mature citizens actually helps fund the welfare bonanza of the rich – a Maltese invention of an ‘inverted Robin Hood system’.