How to maximize health care provision in small island states

Recently Sandra Buttigieg, Frank Bezzina and I have been starting to analyse the Economics of the Maltese health care system, and asking the question how it can maximize health care provision for its citizens. The task was to find out, how to combine the value chains of the public health care system (namely the health centres and the Mater Dei Hospital in Msida, modelled after the UK's NHS) and those of private clinics, in a way that the overall output and quality of care is at its best and accessible to everybody. As of the different shareholder and stakeholder interests, classical private-public partnerships might not be the best solution. But we found more and more that there are other ways of potential collaboration between the systems. So, we are looking into the promotion of medical tourism to boost up case numbers, increase specialization and make investments into laboratory support and infrastructure feasible. There is also other evidence that the kind of contracts doctors are operating on (private practice allowed or not) have an impact on the failure rates of medical procedures. Lastly, every patient who decides for private sector treatment, saves the public sector provision of capacity. The question is whether this potential public saving could translate into a financial incentive for citizens to pick up private health insurances. 

I am happy that the results of the initial work we did together, have been published in the Health Economics Section of the Frontiers in Public Health. Thanks to Sandra's restless editorial work for the Frontiers, it is free to download here. We will continue on this path, and hope not just to make a contribution to Malta, but also to learn from this model for other small states. If you like to join the discussion, you are very welcome.