Citizens pay for a third of the total amount spent annually on healthcare from their own pockets, with the increase in private spending exceeding public health expenditure growth, according to a report.
“Out-of-pocket payment accounts for most private healthcare expenditures and comprises a comparatively high percentage of total spending in comparison to other European countries,” the Health Systems in Transitions report said.
It said people tended to use the private sector to receive more personal attention, to have better continuity of care by seeing the same provider, to set appointments at convenient times and to avoid waiting lists for surgery in the public sector.
General government expenditure comprised almost 64 per cent of the total health bill in 2011 as against 34 per cent in out-of-pocket payments and two per cent from voluntary health insurance.
The report, conducted by the European Observatory on Health System and Policies, a partnership hosted by the World Health Organisation, showed that Malta’s total health expenditure, as a percentage of GDP, stood at 8.7 per cent in 2011, below the EU average of 9.6 per cent. It flagged the sustainability of the healthcare system as a concern, especially given that the island faced an ageing population and rising costs in medicine and technology.
It also spoke about the need to strengthen public primary healthcare services that focused on prevention and community care, cutting costs.
Sarah Thompson, from WHO, said that while increasing efficiency would help in terms of sustainability, to be successful there had to be a broader revenue base.
“Efficiency will only get you so far. In the longer term, you also need to think about broadening the sources of financing,” she said, adding that Malta’s levels of public spending on health were “relatively low”.
When breaking down the money spent on healthcare, the report noted that private spending made up 2.9 per cent of the GDP while public spending amounted to 5.6 per cent compared to the EU average of 7.3 per cent.
There exists a strong political commitment to ensure the provision of a healthcare system that is accessible
The report noted that the private sector accounted for about 70 per cent of primary healthcare contacts. People opted for the private sector as there was better continuity of care.
The report concluded that Malta faced important challenges that affected the sustainability of public finances. “These include a steadily ageing population, which is stretching the supply of a variety of services, including surgery and free medication. Other supply constraints exist, stemming from financial and infrastructural limitations.
“Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and, last but not least, sustainable.
“This is likely to require investment in the health system to revisit existing processes and to shift the focus of care away from hospital and into the community.”
Health facts
• 22 per cent of the population have some form of private health insurance.
• Life expectancy increased to 81 in 2011 from 70.4 in 1980.
• The fertility rate dropped to 1.4 babies per woman in 2010 from two in 1991.
• Some 15 per cent of the population is over 65.
• Malta had a high hospital bed occupancy rate of 82 per cent in 2010, compared to the EU average of 76 per cent.
• The average length of stay increased to 6.3 days in 2011 from 4.7 days in 2005.