Salubrious Thoughts (2)

There are three major and recurring headaches here in Malta.

First on the list is a lagging tourism industry, certainly not entirely due to the global recession. A lot is still lacking from MTA (Malta Tourism Authority), most especially in upkeeping the discipline within its ranks. 

One need only drive past the St. Andrew’s Coast road, past Bugibba and Xemxija to witness the number of hoteliers who simply closed shop, abandoned ship and stripped their hotels to mere and unsightly frames, leaving the shell form skeletons to fester along the main routes, some of them for years on end. Forum Hotel, White Rocks Complex, Xemxija Bay Hotel and Mistra Village Complex are a few that come to mind.

Second in line is our health system, which although boasting a wide network of polyclinics (one in every locality), and excellent medical staff, currently finds itself saddled with a high maintenance state-of-the-art hospital which cannot cope with the number of “emergency” patients and bed space required, plus exhorbitant running costs footed by the tax payer. The problems are partly inherited through a custom of lax social policies which has nurtured an over indulgent public. A recent diagnosis has also laid the blame at the consultants' and surgeons' door, these having complete autonomy, and opacity, on who's lined up for the operating theatres.

The third headache also undermines the first two. It’s the state and general upkeep of the environment we live in. Malta is a tiny island, self sufficient in most respects. This has led to a significant number of industrial estates, incinerators, gas and fuel depots, and also a burgeoning and over-speculative development lobby which moves form site to site like a bull in a china shop. The environment is the greatest problem of all three since its deterioration further aggravates problem one and two.

The solution to the above quandaries has its roots in a sterling salutary environment, and a major embellishment of the thousands of vacant and shell form properties on this island. The solution lies in Home Health.

Home Health ecompasses, but is not limited to Health Tourism (that is tourists visiting Malta short-term for specific operations, also including minor beauty interventions like face lifts). The latter already has picked up well and is benefiting a number of well run private hospitals and clinics here in Malta. Home Health however delves further, first and foremost by attracting foreign pensioners to take up residence in Malta, instead of a short stay for one intervention, and secondly in changing the Maltese citizen’s perspective, looking ahead and seeing their late retirement and twilight years' medical needs also comfortably accessible from their private homes, through modern technology.

We have entered the realm of tele-medecine, where a patient can recover at home instead of in a hospital, surrounded by the necessary equipment and monitors, and under constant supervision from tele-medics via internet or satellite connection. Malta is the perfect location to be advertised for such a set-up. It enjoys year round mild weather, a small size enabling immediate access to all amenities without hour long commuting, and diffused medical, health care clinics and private hospitals. It also enjoys one of the highest broad bandwidth internet connectivities in Europe.

However all these plus points are of little consideration and attraction if one’s residence is constantly engulfed in traffic pollution, construction dust, and the constant jigging of heavy machinery digging up the latest site in our seaside towns.

A look at other countries like the United States reveals a win-win situation between the patient, the medical care insurance, the private clinics and hospitals providing the service. The public hospitals are immediately relieved from precious bedspace.
For example in the US intensive homecare for elder patients with congestive heart failure patients, reduced hospital length stay of patients from 26 days down to 6 days. More figures on Home Health in the US:

• The benefits of home care go far beyond keeping someone in their comfort zone.
• Preventive home health care saves Medicare and Medicaid millions of dollars a year.
• A home-care visit costs Medicare a tenth of the cost of a one-day hospital stay.
• Home care has a proven track record in managing chronic conditions and reducing costly emergency room visits and hospital readmissions.
• The average home-care visit costs Medicare $150; the average hospital day costs $1,500.
• Providing home care to a child with cancer will lower their medical costs by nearly $14,000 a month.
• Adults who are dependent on ventilators will spend more than $21,000 on hospital costs each month. Those who receive home care will spend about $7,000.
• Intravenous antibiotic therapy administered at home is nearly $8,000 less each month than in-patient treatment – and uses the same state-of-the-art technology.
• Nearly 12 million Americans now rely on home health care. Medicare covers only 3.5 million of them.
• 78 million Baby Boomers are nearing retirement age. Scientific studies indicate they will experience higher rates of chronic illness.
• Twelve percent of Americans with chronic illnesses are responsible for 75 percent of U.S. health care costs.
Source -

So it’s very clear that the benefits to all parties are very significant, and most of the infrastructure is alread in place here in Malta. The last piece of the jigsaw is a healthy environment, which is still lagging behind.

What more can be done to accelerate the change in perception needed from the general public to enable the above scenario?

Well, a fourth major headache I refrained from mentioning is the gap between social security revenue, and pensions due within a decade or two.
This uncomfortable state of affairs can be used to tie in perfectly with our vision. If future pensions are dependent on Home Care tourism, and the whole vision is seen by the public as a kind of pension fund that will be translated in future pension payments, then the public will be incentivised to join in accelerating the island’s environmental upgrade. The benefits will be evident immediately since all the property upgrades required will enlist labourers shifted off new constructions and into embellishment and upgrading. Government can incentivise property owners by offering higher pension payouts to property owners undertaking to offer their properties long temr to this national project. Also, the better environment will immediately go hand in hand with our already existent health tourism market, and of course the run of the mill tourism too.

It is granted that the current global financial situation hasn't been too kind on target pensioners abroad, however by the time we have our shop in order, the situation will have hopefully corrected itself, and paper losses partly recuperated.

First published, 24th April 2009.


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