Employees +3.3%; production +8.4% – Value added (88.37 billion) is equal to 6% of GDP – But there is tension on decentralization
The rationalizations of the 90s are a dim memory. Healthcare spending has picked up again, so much so that in the last six years the costs of the NHS have almost doubled (+49.6%). The urge for spot cuts and blind budget constraints could be around the corner again. With the risk of destroying the opportunity for growth represented by the "health chain" which - with the latest maneuver - has just tasted the pleasure of no longer being considered exclusively a "source of expenditure". It is therefore no coincidence that in the second edition of the research on the trend of the "health chain" promoted by Confindustria and carried out by Nicola Quirino, professor of public finance at Luiss - whose text we present in these pages - the invitation to reflect on the effects of the decentralization of functions in the health field stands out in the introduction. "It is generally very difficult to establish whether it in itself increases, or reduces, the level of efficiency/fairness of a health system" - reads the document - "ultimately everything depends on the particular context of reference". "However, if we consider the major European countries, we cannot ignore the fact that the French and English health systems, although highly centralized, absorb a smaller volume of resources and ensure better health protection than the German health system, whose weak point is represented precisely by the lack of homogeneity and duplication of services between the different Länder". The coup de grâce to the current balances-imbalances in the sector comes from the reference to the case of Spain, where the devolution of healthcare has triggered heated conflicts between the center and the periphery and where "the poorest communities fear they will not be able to meet the population's growing demand for assistance over the years". Words that weigh, because they come from the fourth national supply chain by number of employees (1,513.6 thousand; 6.1% of the national total; 86% employees), which boasts a direct and induced value added equal to 12.5% of the national total and realizes 6.5% of the entire national production with a product per employee 6.4% higher than the Italian average (125.7 euros against 118.1). The detailed identikit in the context of the study that takes into account the potential of the sector, the needs of the NHS, the risk of aging, neglecting only to update the research aspect, since the Istat data are still stuck at the 2004 edition of the study. (S.Tod.)
«The particular trend recorded in recent years by health expenditure has led the economic policy authorities, scholars and the mass media to focus almost exclusively on measures aimed at curbing it, ignoring however that the "health supply chain" brings together a set of activities that participate to a significant extent in the formation of national wealth, exert a marked dragging effect on the rest of the economy, absorb a high share of total employment and invest massively in scientific research and technological innovation. In other words, it acts on development processes both indirectly, by creating an environment conducive to the growth of labor productivity and social cohesion (the so-called positive externalities), and directly through the use of resources in its own production cycle and the creation of added value. The supply chain in question - understood as the complex of activities related to the manufacture and trade of pharmaceutical products and medical devices, scientific research in the medical field and pres
