Healthcare, goodbye to small clinics and a cut to loanable drugs

A cut to existing contracts in the hands of suppliers of goods and services to Local Health Authorities and hospitals, slimming care for pharmaceuticals also with a cut in the formulary of loanable medicines, closure of clinics and underutilized hospital wards, undoing the Primary degrees at more than a doctor. The Regions are thus preparing to put their heads on the government block, ready to have almost 2.4 billion destined for health care cut off if not their heads. A sum that will have to be raised in what remains of the year and, therefore, with measures that are anything but painless.

The last summit

Yesterday a new summit between the regional councilors served to finalize the cuts imposed by the stability law which, albeit obtorto collo, the Governors, Veneto excluded, are ready to sign perhaps immediately after Easter in the State-Regions Conference. It will then be up to the government to package everything in a decree law to be passed shortly.

The lion's share will be spent on goods and services, which with the renegotiation of existing supply contracts will have to yield 1.4 billion. A cut that the commissioner Veneto and coordinator of all the Regions for health, Luca Coletto, defines "linear and intended to hit the Regions that have already done the spending review, to the detriment of those that still waste". The mechanism follows that of the spending by Monti, which according to a study by Fiaso, the Federation of local health authorities and hospitals, would have given less than half of the expected savings.

Pharmaceuticals will have to put another 545 million on the counter. About 200 million will come from the advance of the new formulary which will send a few "duplicate" medicines to the attic, another 35 will come from the renegotiation of the price of biotechnological medicines and 310 million will cut the spending ceiling for pharmaceuticals.

The spending ceiling

Which when it is exceeded triggers the "pay back", i.e. the shelf charged to those who produce the medicines.

Also for this reason, the drugs chapter is destined to be subject to filings right up to the last minute. «Among other things - Coletto continues to explain - the fund for innovative medicines, which for ora is mainly used to pay for the anti-hepatitis ones, it is a bluff because the Regions should put the money by diverting those already committed or spent on objective projects, intended for rehabilitation and treatment for specific pathologies ». And that there is no money is demonstrated by the administration of therapies to HCV patients with a dropper.

The rest of the bill will have to be paid especially by hospitals and clinics. The former by closing wards and underutilized beds. Maneuver that will cost the job of more than one Head Doctor, but foreseen by the Health Pact, signed last year by the government and the Regions and now implemented by a ministerial regulation on the hospital network that has just been launched. A cut of the 50% is envisaged on the rates reimbursed to hospitals for inappropriate hospitalizations and of the 60% for the days of hospitalization that exceed the expected duration. On the other hand, clinics with fewer than 40 beds (excluding single-specialist ones) will have to close, unless they join together but exceeding at least the threshold of 80 beds.