Contracted pharmaceuticals fell by 3.4% (after a collapse of 10% recorded 12 months earlier) which did not reach 9 billion and funding was reduced
By IBTimes Italia Editorial | 10/17/2014
Personnel costs have been falling for years (35 billion in 2013), the cost of purchasing goods and services has fallen (another 35 billion), the costs of pharmaceuticals (+6% in one year) and medical devices (2.7% ). Pharmaceuticals with special agreements are down by 3.4% (after a collapse of the 10% recorded 12 months earlier) which does not reach 9 billion and funding has been reduced (-0.6). Revenue is also down (-0.9%). Il settore pubblico-privato, la medicina “convenzionata ed accreditata” pesa per oltre un terzo sulla spesa sanitaria, percentage that has been growing over the years. In some Regions (Lombardy, Campania and Lazio) there is a decidedly higher share than the national average (over 42%).
Despite having reduced the health deficit over the years, the Health Service continues to spend more than it collects. Over the last few years, 9 Regions have had to activate Recovery Plans (Piedmont, Liguria, Lazio, Sardinia, Abruzzo, Puglia, Campania, Calabria and Sicily). Liguria and Sardinia have left the black list. But in 2013 the deficit was overall higher in the other 13 Regions where the Plan is not envisaged (890 against 746 million euro). In the Regions subjected to the Return we have witnessed plans for tears and blood (increases in co-payments, cutting of beds if not entire hospitals). Almost always linear cuts, which also affected the not many outstanding excellences.
Ultimately, health spending has been going down for years, we spend less than our European partners, and when we cut we often don't make a distinction between waste (which exists) and necessary spending. We do little or nothing about the hidden tax of corruption. How does all of this translate? That the LEA (Essential Levels of Assistance) are reduced.
In 2012 there were 7 Regions that did not guarantee these levels: Calabria (21 defaults recorded), Campania (19), Lazio (13), Molise (12), Abruzzo (10), Puglia (8), Sicily (5). Lin Campania it was rejected by the Ministry of Health in the sectors of hospital assistance, waiting lists, prevention, experimentation and management innovations, prosthetic assistance, transfusion activity, emergency-urgency. Lazio in hospital care, waiting lists, home and residential care, palliative care, rehabilitation.
Now the Renzi government it seems he wants to make the usual suspects pay part of the maneuver: si chiedono tagli miliardari alle Regioni e si impostano clausole di salvaguardia che prevedono l’intervento diretto del governo sulla Sanità qualora le Regioni non riescano a racimolare quanto ‘dovuto’.
But what should the Regions cut? If 4 to 6 billion are asked of those who have already given ten times as much in recent years, where will the regional governments go to raise cash? Renzi talks about waste. Which? If you know, tell me. Altrimenti, per accontentare la spending, spingi le giunte regionali ad aumentare imposte locali (Padoan dixit) e a tagliare il tagliabile sui servizi (non solo sanità). Senza dimenticare il taglio dell’IRAP, il cui gettito finanzia a livello locale proprio la Sanità. Se si procederà all’italiana, ancora tagli lineari, gli effetti si faranno sentire sulla vita e nelle tasche degli italiani.
Fewer beds, perhaps less staff, less assistance for the elderly and disabled, an increase in tickets. A further lowering of quality, which over the years has fueled the phenomenon of healthcare mobility, especially from the South. The primary deficit of health expenditure has been drastically reduced over the years, however affecting the Levels of Assistance. Now, if a new rain of billions is requested, it will touch the living flesh of the System.
