Time to face reality

Maybe considering all that is presently happening with regards the discourse on the national agenda, now is not the ideal time to speak about the sustainability of our national healthcare. My interest is not political and whether privatisation of certain healthcare services is the way forward from a policy decision. My interest is the economic sustainability of our national healthcare service. Recently a person close to me had to undergo surgery. He has been living in excruciating pain for many months. All specialists indicated that unless operated his pain could not be sorted. His quality of life deteriorated fast as once an active individual, could barely do a few walking steps and was living on pain killers round the clock. After months of waiting and enduring unbearable pain with no scheduled operation at Mater Dei in sight, he had no choice but to undergo the procedure at a private hospital, incurring a bill of thousands of euros. Luckily, he was somehow able to foot this bill.

This brings me to my long-standing belief that we are kidding ourselves when we believe that free public healthcare services for all is sustainable. What we end up having is a national healthcare service which is rationed, which ultimately means that those that have no option must endure hardship.

A cursory look at this country’s recurrent expenditure on national healthcare shows that while in 2013 this recurrent expenditure stood at €354m, this has grown to €930m in 2023. Having said so the recurrent health expenditure has remained within the range of 4.5-5% of GDP.

However, it is evident that although we have seen an almost threefold increase in recurrent national healthcare expenditure, the situation on the ground is that it can never be enough. I will try to explain why.

Firstly, the demands on our national healthcare services have risen due to both an increase in the resident population and a surge in tourists visiting us. Add to this the fact that we are a population that has its average age on the increase, which means that the probability of a portion of our resident population needing regular medical attention is also increasing. Ultimately, healthcare is also one of those areas that suffers from its own success. As healthcare improves, people are likely to live longer, which subsequently increases the demands on healthcare services.

In my humble opinion, rather than living under the illusion that things are sorted within the context of free healthcare services for all, we should be working towards achieving more sustainable solutions. At least at incentivising those who can and are willing to get private healthcare insurance, on the same lines that we incentivise through tax credits those that opt to send their children to private independent schools. This tax incentive must be structured with regulations stipulating that if you hold private healthcare insurance but choose to receive treatment at a public hospital, a bill will still be issued to be paid by your health insurance provider.

Just like the traffic problem, the growing unsustainability of the current national healthcare system will not disappear simply by ignoring it.