Issue link: https://maltatoday.uberflip.com/i/939870
11 maltatoday SUNDAY 11 FEBRUARY 2018 News Maltese prefer paying for healthcare rather than face waiting lists delays If countries with limited means can achieve virtual absence of waiting lists – what excuse can there be for countries like Malta to keep having waiting list problems? PAUL COCKS MALTA is among the top six EU countries with the highest private spend on health - 31% of total health expenditure - the majority of which is paid out of pocket. The Euro Health Consumer In- dex scored the country exception- ally well on access to healthcare, health spending, and range of ser- vices offered, but excessive waiting times were identified as one of the main reasons why so many Maltese choose to pay out of pocket and seek private treatment when they could get most treatments for free through the public health service. The ECHI for 2017, an independ- ent report drawn up by Health Consumer Powerhouse (HCP), notes that these out-of-pocket di- rect payments, as a share of total health expenditure, totalled 29%, significantly higher than the EU average of 15%. Out-of-pocket spending, in fact, accounts for 5% of total household final consump- tion, which is the second highest in the EU. The report says that if Malta is ever to cut its waiting lists for health services, it should look to what other small countries in the European Union are doing. It high- lights how Slovakia has radically improved access to treatment, how tiny players such as Macedonia and Montenegro have used e-health to abolish patient waiting and how low-key Finland climbs in the In- dex year by year. Healthcare is basically a process industry, and as any professional manager from such an industry would know, smooth procedures with a minimum of pause or inter- ruption are key to keeping costs low. If countries with limited means can achieve virtual absence of wait- ing lists – what excuse can there be for countries like Malta to keep having waiting list problems? Malta was ranked in 23rd place overall in the EHCI, with 642 points out of a possible 1,000. The report notes that Malta enjoys de- cent accessibility, but is not too strong on treatment results. "There seem to be gaps in the public subsidy system of Maltese healthcare," HCP says. "This is par- ticularly prominent for drug subsi- dies; many Maltese do not bother with receiving a subsidy. The result is that Malta has little data on drug use." The EHCI notes that in spite of financial crisis-induced austerity measures, such as the much pub- licised restrictions on the increase of healthcare spend, European healthcare keeps producing better results. Survival rates of heart disease, stroke and cancer are all increas- ing, even though there is much talk about worsening lifestyle fac- tors such as obesity, junk food consumption and sedentary life. Infant mortality, perhaps the most descriptive single indicator, also keeps going down, and this can be observed also in countries such as the Baltic states, which were severely affected by the financial crisis. Life expectancy in Malta is high and the population spends an av- erage 90% of their lifespan in good health, longer than in any other EU country. The health system provides universal coverage and access to a comprehensive set of services. New public-private partner- ships aimed at increasing capital investment and quality of care are changing the role of the Ministry of Health from a pure provider to that of provider and contractor of services. Health spending has increased steadily since 2005, up to €2,255 per capita on health care, com- pared to the EU average of €2,797. This equals 8.4% of GDP, below the EU average of 9.9%. Malta EU Life expectancy at birth 81.9 80.6 Amenable mortality (per 100,000) 123 126 Unmet medical care needs (% of population) 0.8 3.2 Health expenditure per capita (PPP) €2,255 €2,797 Out-of-pocket expenditure on health (% of payments) 28.7 15.3 Malta was ranked at 23rd place overall in the EHCI, with 642 points out of a possible 1,000. The report notes that Malta enjoys decent accessibility, but is not too strong on treatment results JAMES DEBONO MALTESE youth participation in NGOs is 15 points lower than in the entire EU, a Europe-wide sur- vey has revealed. Maltese participations in sport clubs is 18 points lower than the EU average. The Eurobarometer survey shows that 62% of Maltese youths aged 15 to 30, have not partici- pated in any activity organised by non-governmental organisations in the past year – an increase of 7 points from 2014. Only Cyprus, Hungary, Romania and Slovakia registered lower par- ticipation. Maltese youths were most likely to have attended activities organised by sports clubs (11%). But significantly this participa- tion declined by 17 points when compared to 2014. This was considerably lower than the EU average where 29% attended at least one such activity. Also low was Maltese youth par- ticipation in leisure-time youth clubs: 7% in Malta compared to 20% in the whole EU. Participation in cultural organisations was also significantly lower in Malta, 6% compared to 15% in the whole EU. The percentage of young people who attended activities organised by a political organisation however increased from 3% in 2014 to 5% now. This increase coincided with the general elections held in June 2017. Only 1% of young people participated in activities organised by environ- mental NGOs, com- pared to 5% in the whole European Union. The survey did not categorise participa- tion in religious NGOs. This may explain a high rate of 9% of Maltese young people active in activities organ- ised by "other" NGOs. Maltese youths were also among the least likely to participate in voluntary activities. While 31% of young people participated in such activities in the whole EU, only 23% of Maltese young people did so. Yet nearly a tenth (9%) of Mal- tese youth have been at least once abroad for the purpose of volun- teering, reflecting the EU average. Austrian and Italian youths (both 79%), and Maltese (78%) were the most likely to have voted in local, national or European elections in the previous three years. Luxem- bourgish (35%), Irish (36%) and Belgians (40%) were the least likely to have done so. Maltese youth a laggard in NGO participation Young people attending political activities increased from 3% in 2014 to 5% in 2017, while sporting NGO participations fell by 17 points to just 11%