Def and cuts to healthcare: the government-Regions pact on the skin of the sick

Fedaisf editorial staff

April 18, 2015

The Def is preparing the conditions to pluck health care, the Regions have given themselves the worst image they could give. Individual sufferers in many cases they will not have the innovative drugs which are on the market, i.e. the most effective ones; they will not have the appropriate prostheses but only the less expensive ones, they will not have the necessary treatments but only those compatible with the company budgets, they will not have complete care because the cost for personnel in 2015 is lower than in 2010. Whoever wants appropriate care he'll have to put his hands in his pockets

Of Ivan Cavicchi | April 18, 2015 | Daily fact

The def, the financial economic document, this year for healthcare it is more obnoxious than usual. On the one hand because the current government as if it were a vampire continues to suck blood from an anemic, just like those who preceded it. On the other hand because this time to be a vampire there is its historical victim, the one who has always protested against linear cuts, that is the regions with the only exception of Veneto.

AND yes, because you must know that i 2.637 billion in cuts envisaged by the Def consist of 2.352 billion as a voluntary cut that the Regions have decided to make to the national health fund, While 285 million is a cut in healthcare construction decided with an agreement between the State and the Regions. How could this happen? You will remember that last year Renzi had already asked the Regions but in a generic way for a contribution of a few billion savings, leaving them the freedom to decide where to get them and how to get them. The Regions, with the only opposition from Veneto, have decided to obtain them from healthcare but, listen, listen, this happened in the aftermath of a government-Regions pact which had sanctioned, think about it, even the refinancing of the National Health Fund. At this point the question arises: is it ever possible that those required savings could not be obtained in any other way and from other sources, leaving healthcare alone?

The same question was asked Cesare Fassari the director ofHealth newspaper, the leading online newspaper of the sector:“what is really perplexing ... is that none of the 'savings' items concern other expenditure items of the regions. There is no mention of directors' salaries (almost one billion a year in all), of external consultancies (800 million in all a year), of transfers to the various 'regionalised, provincialised, municipalised and consortium companies', to which each year more than 3, 2 billion euros. Nothing on the expenditure of non-healthcare goods and services, which reaches the remarkable figure of 6 billion a year (Regional budgets - Istat 2014)”. Fassari also makes some calculations and some hypotheses: “waive half of the fees of the 1,100 regional councilors (which we travel on average for 200,000 euros a year) would, for example, have meant setting aside almost 500 million euros (more or less the entire maneuver on pharmaceuticals) and giving up external consultants for a year would have meant saving 800 million, perhaps useful for not further stifling investments in the most disadvantaged areas of the country".

Now the damage is done the Def is preparing the conditions to fleece the sanity, the Regions have given themselves the worst image they could give, the one evoked by Hume, that is, of a political class that prefers the collapse of the world to a scratch of its finger. Dear Chiamparino, You cannot imagine how much suffering this Def will cost materially and concretely to sick people because of you. Individual sufferers in many cases they will not have the innovative drugs which are on the market, i.e. the most effective ones; they will not have the appropriate prostheses but only the less expensive ones, they will not have the necessary treatments but only those compatible with the company budgets, they will not have complete treatments because the cost for personnel in 2015 is lower than in 2010.

After this Def everything that should be appropriate, adequate, pertinent to a need will simply be what the Def passes. And who will want appropriate treatment he'll have to put his hands in his pockets and all this because the president Chiamparino, naturally in a metonymic sense, in order to safeguard his own guarantees, has decided to present the expected savings account to poor unfortunates.

Yesterday I was in Milan at symposium from the Paracelsus Foundation, for world hemophilia day and besides me also a couple of deputies from the Senate Health Commission. After having made our reports, a lady stands up from the audience who, visibly exhausted by the clichés she had pinned down, makes a list showing us with simplicity, but also with great effectiveness, the problem of a void horribilis of thought, of politics, of ideals but also transferring the discomfort of those who feel the problem of a problem with regard to the government's health policies blatant intellectual dishonesty.

THE clichés, the most common, were: “the blanket is too tight now”, “We are now at a crossroads.". The adverb at this point to express ineluctability and resignation, and the metaphor of the blanket and the crossroads to force us to one choice without choice. That is, to make us drink the def, the Regions we have, the linear cuts, the broken rights, the suffering of the people, etc. On the train, on my way home, that lady's polemical gesture came back to my mind. With that gesture, which had irritated some of us quite a bit, the lady had exposed bad faith of those who combine the dichotomous logic of the crossroads with the coercive logic of the blanket.

The dichotomy to divide the health problem in two disadvantages, one smaller and one larger, and let you choose one disadvantage anyway. Coercion to rule out a third possibility: for example, to refuse the crossroads and widen the blanket, that is, to solve the same problem but with benefits for all. That lady had hit the mark, when we talk about crossroads and deck it's because:
– There is no reforming thought able to imagine a third possibility which, in order to be such, needs a real reforming thought.
– The political will is lacking to fight vampires, profiteers and exploiters, so in the end you have to justify them.

And how to justify them? With a Def of almost 3 billion euro linear cuts to healthcare and with crossroads and blankets.

Regions: ok to maneuver with amendments. From supply chain concerns about pharmaceuticals

The Text of the Understanding

The essential amendments of the Regions

N.B.: l’immagine “l’onestà è reato” è tratta dal “Venacoliere”