Costly care

▪️ Costly care ▪️ Sadder ▪️ AI and the Universal Basic Income ▪️ Benedictis

The Government’s announcement that around 650 couples on the waiting list for IVF treatment will be able to receive it at a private clinic, thanks to a €6 million investment from the government, is indeed welcome news.  The government is already refunding the cost of IVF-related medicine to 285 couples who chose to undergo the procedure last year. 

Considering that Malta has the lowest fertility rate in the EU and that our population is ageing fast, the imperative in any government action should be to facilitate life for any couples wishing to have children.  Failing that, our economy will eventually shrink, standards of life will go down, and pensions and social expenditure will become unsustainable.  

Apart from socio-cultural considerations and the nation’s survival, the proposed expenditure is economically sound at €9,230 per child.  Consider that productivity per person in 2020 was €41,000; assuming that any additional person in the population will have a working life of 45 years, the discounted net present value of a person’s productivity over his lifetime would be around €531,000.  This is a good investment indeed, apart from being socially just.

Another decision that is equally welcome, even if it comes late in the day, is the decision to award around €1 million in compensation to some 25 persons who had been confirmed to suffer from a type of disability following their ingestion of Thalidomide   ̶   the infamous pill that was normally prescribed for pregnant women suffering from morning sickness.   Despite the drug being prohibited internationally in 1961 after it was found to have caused a number of miscarriages and of deformed babies, it was still dispensed in Malta until 1968.

Sadder

The Roman Emperor Marcus Aurelius once said, “Remember this, that very little is needed to make a happy life.”  Centuries later, Mahatma Gandhi added this other jewel: “Happiness is when what you think, what you say, and what you do are in harmony.”  Today, it looks as if, even if the comforts of modern life far exceed those of the average Roman nineteen centuries ago, what we think, say and do are way short of harmony.

This perhaps explains why Malta has slipped down the global happiness rankings. According to Gallup’s 2024 World Happiness Index, Malta has dropped to 40th place out of 143 countries, eight places less than where it was in 2012.  (Yes, annoyingly, Finland came out on top, for the seventh straight year.)

The economy may be the envy of the European Union, but the Maltese are becoming a dyspeptic bunch, anxious about the future and uneasy about foundational institutions, from the government to the press to organised religion. Yet all are not equally sad.  Gozitans are reported to be happier than Maltese; young people more than adults; women more than men; the married more than the unmarried.

One distinction that holds true today has prevailed for decades: conservatives are happier than liberals.  This is a global symptom of political difference, but it is particularly strong in Europe.  According to various studies, liberals are also far more likely than conservatives to report having been diagnosed with a mental illness.

I for one fully understand that: since the arrival of Donald Trump on the scene, I worry significantly more than I did before he was a mere philanderer in New York, and the same applies when I think that the dangerous Norman Lowell might garner enough votes to make a difference in the European elections.

The confused nature of politics in Europe today can be explained by an elegant paradox of political science.  Surveys consistently find that people who live in countries run on social democratic lines are happier than those in neoliberal ones. Thus, Scandinavians are happier than Americans or the Maltese people. But if you do the measurements at an individual level, the pattern is reversed: people of conservative views are happier than progressives.

Adam Okulicz-Kozaryn, the lead author of a study from The State University of New Jersey under the title ‘The Subjective Well-Being Political Paradox: Happy Welfare States and Unhappy Liberals’, says that liberal governments tend to do more to shield citizens against certain hardships, such as unemployment and poverty, which can make people feel happier overall.  On the other hand, conservatives rate their well-being higher than liberals because conservatives more readily support and rationalise the status quo, thus, believing that socio-economic hardships are a result of individual shortcomings.

The confusion reigns in Malta as it does in Europe. The Left is formally social-democratic but conveniently neoliberal in practice; the Right … well, I don’t know what exactly it stands for, which explains why many of its supporters switched parties but do not have the stomach to switch back even when they are clearly dissatisfied with their choice in 2013.

The happiness gap between conservatives and liberals has long vexed social psychologists and political commentators.  But there is a solid body of research that shows that progressives are unhappy because they are rightly conscious of social injustices and dangers. Thus, their unhappiness reflects social concern.  On the other hand, conservatives are less concerned with equality of outcomes and more with equality of opportunity.  This group presumably benefits from the cultural myth of an equal playing field in which exceptional social positions are thought to be earned through hard work and talent rather than inherited through codified privilege.

Progressives like me may feel alienated in contrast to our conservative peers. 

AI and the Universal Basic Income

The computer scientist regarded as the “godfather of artificial intelligence” says  governments will have to introduce a universal basic income (UBI) to mitigate the impact of AI on inequality.  Professor Geoffrey Hinton says that social benefits would need to feature fixed amounts of cash to every citizen, particularly because AI would eliminate lots of mundane jobs.

While Hinton believes that AI will increase productivity and wealth, he thinks the money will go to the rich “and not the people whose jobs get lost and that’s going to be very bad for society”. Until last year he worked at Google, but he left the tech giant so he could talk more freely about the dangers from unregulated AI.

The concept of UBI amounts to the government paying all individuals a set salary regardless of their means.  Critics say it would be extremely costly and divert funding away from public services, while not necessarily helping to alleviate poverty.  One estimate for Malta by Geoffrey Saliba  and Raisa Galea, published in the Green European Journal,puts the cost at between €4.5 and €5 billion annually (around 24% of the GDP), though this estimate is questionable.

What is certain is that AI will affect almost 40% of jobs around the world, replacing some and complementing others, going up to 60% in advanced economies like Malta’s.  Kristalina Georgieva of the International Monetary Fund says that roughly half the exposed jobs may benefit from AI integration, enhancing productivity.  For the other half, AI applications may perform key tasks currently performed by humans, which could lower labour demand, leading to lower wages and reduced hiring. In the most extreme cases, some of these jobs may disappear.

AI could also affect income and wealth inequality within countries.  This could take the form of polarisation within income brackets, with workers who can harness AI seeing an increase in their productivity and wages while those who cannot fall behind. 

The effect on labour income will largely depend on the extent to which AI will complement high-income workers. If AI significantly complements higher-income workers, it may lead to a disproportionate increase in their labour income. Moreover, gains in productivity from firms that adopt AI will probably boost capital returns, which may also favour high earners. Both of these phenomena could exacerbate inequality.

In most scenarios, AI will likely worsen overall inequality.  This would be troubling and suggests that policymakers must proactively prevent the technology from further stoking social tensions. It is crucial for countries to establish comprehensive social safety nets and offer retraining programmes for vulnerable workers. In doing so, we can make the AI transition more inclusive, protecting livelihoods and curbing inequality.

Benedictis

Mother Abbess Sr Maria Adeodata dei Marchesi Testaferrata De Noto   ̶  the last surviving Benedictine cloister nun at St Peter’s Monastery   ̶   has declared she is holding the fort against unspecified forces that, she claims, “are trying to make my life hard so that I surrender.”  The Mother Abbess believes that these forces are “dying to get their hands” on the premises and turn them to commercial use.

The story ran in the Times of Malta, with the correspondent remarking that the Abbess has a clear animosity towards the Curia and its ways.  She believes this is reciprocated by the Curia.  But she warns: “I am not going to give in … I will continue to struggle until the last minute and then we will see …”. 

For the record it must be said that the Archbishop’s Curia acknowledges that it does not own the monastery and has made it clear that it is not aware of any plans to take over the property and sell it for commercial purposes.  But, as the saying goes, there’s no smoke without fire.  After all, it appears that the coffers of the Benedictine nuns   ̶    consisting of land, properties, and investment in the Church’s property bond fund   ̶   were passed on to the Curia in the 1980s to be administered by it.  The Abbess obviously feels aggrieved that she is dependent on the Curia for financial support.

She jokes: “I am sure God is not going to let me down. I was faithful to him all the way! Otherwise, we will have words,” reminding the correspondent of the Times of Malta that her surname is Testaferrata (hard head).

Mother Abbess Sr Maria Adeodata dei Marchesi Testaferrata De Noto. Photos: Karl Andrew Micallef/Times of Malta

The huge 500-year-old monastery once accommodated 60 nuns, but vocations having long dried up.  The prestigious prime property at the entrance to Mdina is now home to Sister Adeodata only.  Six months ago, the last nun in her community passed away, aged 99.  Today, the abbess carries the weight of the 800-year-old legacy built on the dowries of the mostly-noble nuns with which the property had been bought.

The feisty abbess has been in contact with her counterpart in Umbria, in the hope that some young novices from the Philippines may be sent to continue her mission in Malta.  One thing she thinks will work in her favour is that the harsh rules that made life hard for the cloistered nuns three decades ago, have since been relaxed.  She had a hand in this, though it apparently was after the order had lost six young novices whose lives had been made impossible by the previous abbess.

One would hope that, if Sister Adeodata fails in her search for new nuns, the monastery would be preserved as a museum and a spiritual space.  In other countries, facilities that offer end-of-life care to terminally-ill patients are on the increase.

A high percentage of terminally-ill patients are faced with emotions such as anguish, fear, depression, anger, and dissatisfaction   ̶   emotions with a high emotional and spiritual load.  It is well known that spirituality is a priority in the fundamental objectives of palliative care work to improve patients’ quality of life.  Spirituality has nothing to do with one’s religion, which can overlap or exist separately, from spirituality.

Perhaps the Curia, the Benedictine Order, and Hospice could get together to offer such a facility in Malta. There’s no reason why people who could afford to pay for it shouldn’t do so, even if other less-fortunate patients would not.

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