STAT+: How a for-profit health system’s push to expand ended in disappointment for a tiny island nation

Protesters in the tiny Mediterranean nation of Malta converged last October on the 18th-century Baroque palace housing the prime minister’s offices chanting “thieves,” and unfurled a massive banner on the steps emblazoned with the words: “Bring back the €400 million now.”

The object of their furor wasn’t just the government. It was also Steward Health Care, the medical conglomerate that made Malta the first stop in its aggressive bid to expand internationally, even as its chain of hospitals in Massachusetts teeters on the verge of bankruptcy.

The €400 million figure is the amount Malta’s opposition party claims the government paid an affiliate of Steward and another company over an eight-year period to provide medical care to its citizens and transform three dilapidated state-owned hospitals into world-class institutions.

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