Long-term care in Thailand: A Swiss Perspective

In Thailand, private investors from Switzerland are funding a resort for older people in need of long-term care. This pilot Project offers 50 places in a nursing home focused exclusively on Swiss patients and their spouses. According to the investors, the resort’s services include twenty-four-seven assistance, comparable to the standards applied in Switzerland. Due to an overwhelming public and private demand for the limited number of places, follow-on resorts are planned not only for persons in need of long-term care, but also for patients suffering from burnout or addiction.

In Switzerland, more than one hundred thousand older people are in need of permanent medical assistance and experts estimate that this number will triple until 2050. Research revealed that there would be an additional demand of one hundred thousand places in nursing homes in the next 15 years. The problem is that the average monthly costs related to long-term care is about CHF 11’000 (USD 10’000) per person, what cannot be funded sustainably neither by the current Swiss health-care system nor by private contributions. From this perspective, the resort in Thailand is both an attempt to approach the demographic problems of modern societies, but also a profitable business model. Because the monthly costs for long-term care in Thailand are less than half of those in Switzerland, the private investors are calculating with a financial return of more than five percent for their resort.

I have a somewhat uneasy feeling regarding long-term care resorts for Swiss older people in Thailand due to two reasons. First, I dislike the imagination of living in one of the richest countries in the world, which society is not able or willing to find sustainable approaches or solutions for its demographic issues. In my opinion, purely economic considerations fall short of taking into account the complex problem of increasing health-care costs in most of modern societies. In short, sending persons in need of long-term care to Thailand because of economic reasons is the failure of a whole society to take over responsibility and to show solidarity with its older people.

Second, sending older people to Thailand because of the financial costs related to long-term care is a striking example of the economic primacy in many of today’s social-political considerations. For example, a leading Swiss expert in the field of gerontology recently stated that if a dement person does not recognize the own apartment anymore, it would not make any difference if he or she lives in Switzerland or Thailand. This statement completely neglects an older person as being embedded in a family or a broader social context. To find sustainable and integrative solutions for the complex problem of the rising health-care costs, economic considerations have to serve the needs of a society and the people it is made of.

Tom Schneider

Titanic disasters - or stories of successful, sustainable life?

11^th April: A hundred years ago, the pride of the White Star Line, RMS Titanic, was steaming westward on its maiden voyage to the New World. What happened around midnight between the 14^th and the 15^th of April has become part of our collective archetypal memory: a titanic disaster, caused by a blend of arrogance and ignorance, and a false feeling of safety.

Why has this tragic accident achieved such an epic status? The 20^th century has seen so many human tragedies and disasters – why this one? It happened even before the First World War that showed how effective and efficient industrialized nations were in killing enemy soldiers, and how ineffective and inefficient they were in solving political problems.

It happened before the Second World War that not only brought an unprecedented amount, but also unprecedented qualities of distress and suffering to humans.

How could the sinking of RMS Titanic create or keep its fame as an archetypal disaster of the 20^th century?

Many people have speculated about this question. Let me try it anyway: First of all, it was not a 100% man-made disaster. Travelling by ship was almost as safe back then as it is today. What if the Iceberg had been drifting by the ship at safe distance? To a certain extent, it was just bad luck. It was a risk most of us would have taken. It was an accumulation of unfortunate circumstances that (hopefully doesn’t, but) could happen to any of us.

Second – and even more important – I think it was the moment when the 20^th century lost its innocence. The RMS Titanic was a symbol of the achievements of a new area: High tech, top luxury, giant size, top speed; it seemed that man-made technology could break the chains of the old ages, reach new horizons and open the doors to a new quality of life.

The big cities of the early century offered a modern, urban lifestyle that brought an end to old fashioned traditions and gave freedom to the individual. The Titanic was a symbol of a new lifestyle. It offered fast and comfortable travelling to business people, back and forth across the Atlantic Ocean. And it offered affordable transfer to people on the third class decks: emigrants of Old Europe on their way to the pursuit of happiness in the New World.

Literally “out of the blue”, within less than a few hours, all these visions, dreams, lifestyles and hopes that had shown a way into the new century, were destroyed. The unthinkable had happened, the unbreakable was broken, and the unsinkable had sunken to the ocean floor: a titanic disaster disenchanted the young century. The reasons – Ambition? Unthoughtfulness? We will never really now. What we do know: It was the absence of true leadership - the ability to responsibly use the possibilities of a new technology, to adapt to changing external conditions, to take responsibility for human lives.

Many ships have crossed the sea since then. And a new century is about to leave its childhood behind. Has it lost its innocence yet? The archetypal incident must have been 9-11 2001.

While the Titanic disaster was the moment of truth with respect to the limits of new industrial technologies, 9-11 was the moment of truth with respect to the limits of new communication technologies in a global village. Hate and fanaticism keeps mankind from becoming global sisters and brothers through internet, mail and social media.

New technologies, new opportunities, new ages and centuries don’t automatically lead us into a bright future. It takes leadership: responsibility, respect and regardfulness, to make this world a better place, and to create collective archetypal memories which tell us stories of successful, sustainable life.

Christoph Weber-Berg