Tag Archives: Italian elections

How does the Italian health system work?

5 Lug

The issue of regional health does not touch the regional electoral campaign at all nor is it investigated in the media, despite the great attention aroused by the Covid-19 pandemic.

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About our specific, Health in Italy was protected as any country by two articles of the Constitution

  • 32 – public health for the most deprived
  • 38 – workers’ mutual funds

Otherwise it is until 1974 when Mutual Insurances crashed for lotting and all Healthcare system went under political regional management.

In practice, the workers’ mutuals have since been canceled, and the health care that was sufficient for the poor has been extended as’ universal ‘.

Here, the State and the Region determine how much to withdraw from my income and also by paying a lot the Constitutional treatment ‘for the poor’ of mine undergoes continuous cuts.

The emergency became the norm, replacing the free consociative system with one under political control, so tracing a long shrine of corruption scandals and regional waste and debt far greater than Greece. 

I mean you remember the collapse of our parties of the First Republic (1992), breakthrough of state budgetary and liquidity ceilings  of State (2010), conflicts (2020 Covid) on accountability and tasks between the State (money lender) and regions (money spender).

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As you have to know also that the first mafia infiltration known today in the social-health sector dates back to 1946, when Dr. Navarra killed the director of the hospital of Corleone (Sicily) to take his place and start the chain of underworld and crime from which was born the gang of the two bosses Riina-Provenzano.

In 1988 most of the public health professionals of two Calabrian provinces were arrested or removed for mafia investigations. Over the past 19 years, the municipalities commissioned for Mafia connections are over 200.

In this contest, Italy (central State) advocated in 2001 reforming our Constitution and now no longer has its own health skills.

General safety of public health is shared with the Regions, everything else is not even mentioned.

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In short, the Italian state has been trying for years to intervene for chronic and / or rare diseases, given that it cannot impose its own rules, but finances our personal care in toto, so the National regulation of Healt-care System provides good rules:

– Interregional centers and facilities for rare diseases if equipped with medical specialties, experience in a suitable number of cases, structural performance capacity  (the Regions have vice versa set up the ‘reference’ centers, bypassing these parameters)

Diagnostic Therapeutic Assistance Paths (PDTA) for rare diseases that define the performance and accessibility to which the patient is entitled 
(rarely adopted by Regions)

Essential Care Levels (LEA) for the most common chronic diseases as hypertension 
(in many regions the benefit consists of a mere exemption from payment)

– Priority destination for services in the patient’s territory (ASL or AST)
(regional political governance concentrates services for rare or chronic diseases in a few huge hospitals, what has given and is giving enormous problems for the Covid-19 to millions of people remained without cares)

Healtcare electronic cloud folder
(which not only regional services fail to acquire, but also large university polyclinics )

Home or proximity nursing services
(rare)

Jurisdiction of the Centers for all certifications and prescriptions relating to rare diseases, including other specialist consultations, occupational medicine, assistance and welfare 
(no omogeneity between different regions and in same center by patients)

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Please note:

  • Healthcare professionals, including medical faculties, and associations each refer to the rules of their own regions, often proposed or shared by themselves. They do not necessarily also refer to state regulations, which are not ‘mandatory’ as mentioned
  • Official statistics are in the EU / OECD average, but about half of the structures are unresponsive by ever. If the efficiency of these structures that do not confirm the standards were half of the others, the overall Italian average could be lower than Western standards.
  • We have no data on the ‘no profit’ even if it absorbs the 5×1000 of the taxes, besides donations and sponsors.

Some days ago Cittadinanzattiva National Secretary intervened in the Parliamentary Commission to ask – in a European nation that is considered ‘advanced’ – elementary things such as:

territorial assistance, with the recognition of a more central role to family doctors, pediatricians and pharmacies, as well as the homogeneous adoption throughout the territory of the distribution on behalf of drugs and the electronic health record ”.

Even for the large masses of chronically ill patients with essential levels of care, the situation is such that even today “it is necessary to encourage, after evaluation by the specialist doctor, the administration of drugs outside hospitals, using the territorial branches of the ASL / ASST or the patient’s home.

It is also necessary to provide for the possibility of longer-term therapeutic renewals or to be carried out using alternative channels such as telemedicine or through the electronic transmission of clinical documents useful for re-evaluation, also avoiding the repetition of tests already carried out in another region to obtain them renewal.

Clarify who is the risk certification competence deriving from immunosuppression or from results from oncological pathologies or from carrying out life-saving therapies, in order to stay at home and with what timeframe it must be certified, so as not to put at risk large categories of fragile workers”.

The issue of regional health does not touch the regional electoral campaign at all nor is it investigated in the media, despite the great attention aroused by the Covid-19 pandemic.

Without rehabilitating healthcare and freeing workers’ mutual resources, Italy will not be able to reduce debt or corruption.

Demata

Italy with a new parliament: what about the risk of instability?

9 Mar

When the politicians promises are addressed to the voters waving rights / duties, ie principles that refer to philosophy, the disaster is announced. Concrete solutions can only be achieved by taking into account also economy and technics: the triumph of politics is assured only if voters and elected recall that to link them is the desire for well-being, based on common sense for the common good of any well administred community.

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Yesterday the European Commission chaired by Valdis Dombrovskis announced that it is ready to receive a Economic Financial Paper (DEF) from Italy based on “a scenario with unchanged policies”, as happened in other countries that needed time to form a new executive after the elections.

Three weeks ago, our Parliamentary Budget Office in the last Focus on public finance announced that, “as in the past year, in the European surveillance area, the request for corrective measures that bring the balance back to a level consistent with compliance with the rules “.

In other words, the reality is in two chances: or the actual but residual Gentiloni’s government issues a “no policy change DEF” (since it can not do otherwise, being interim), but this DEF will have to be voted by a parliament where M5S and Lega they have a narrow relative majority, or a new government is formed quickly and has already a shared plan of structural reforms (at least three-year terms) for Italy, that is impossible.

Meanwhile, according to the numbers (Italian and international) and as Dombrovskis predicts, “there are still challenges to be faced”: in Italy we see that growth remains substantially below the EU average, low productivity (that is the cost of labor and services) is holding back growth, the high level of public debt persists and questions remain on the banks, in particular the high stock of impaired loans (Npl), which – apart from the financial exposure and the credit crunch – is tantamount to talking about the efficiency of the PA and the usual and notorius speculators.

It is, therefore, a very bad premise that – not even 24 hours after the European notice – Di Maio announce that the DEF “must be approved by an absolute majority of Parliament, so the Movement will be decisive. This will be an opportunity to find convergences on issues with other political forces. We are already working on a proposal that we will make known in the coming days ».

The M5S economic policy project seems to point to a profoundly modify of the national financial planning of the next three years with the support Lega and other right wing parties, BEFORE any government is installed, transferring items of expenditure from one chapter to another, without have time to accurately verify neither the application regulations nor the actual costs nor – at least – which expenses would be cut and with which consequences for all.

By the way, if no government were to be formed after this ‘shot’ and this  parliament will ‘self-dismiss’ to go to new elections, Italy would end up having to live for months and years with incomplete rules, untold rights and duties, costs and budgets out of control, a restless public opinion.

What would happen if – without a government that would follow with its own decrees and without even agreeing with the trade unions and companies – it is approved ‘on paper’ the minimum wage for those 2.5 million workers among employees, quasi-subordinate and self-employed people who are paid at levels below the contractual minimum and below the poverty thresholds?

And, without a government and without unequivocal accounts, how would the revaluation of the contributory pensions promised by the Lega as the Movimento Cinque Stelle under the heading ‘abolishing Fornero’: the start of a bankruptcy process for our public insurance sistem and its privatization?

We do not risk default, because we have an “adequate repayment capacity” as the rating agencies call it, but different Administrations (even Regions or Comuni ones) could end up in bankruptcy, while public payments would slow down with an increase in undeclared debt, if we shall go in search of the fortune to then stop at the edge of the abyss as happened in Greece.

Since we are talking about a hundred billion in total and a good share of Italians, apart the markets, our spread and Eurozone, Mattarella’s appeal to the leaders arrives punctually: “We still have and we will always have need a sense of responsibility to be able to place the general interest of the country and its citizens at the center”.

In fact, since February 26, our stock indices are going wrong: the FTSEMib has lost more than 3.5%, as the FTSE Italy Mid Cap (-3.09%) and the FTSE Italy STAR (-3 , 55%), while the friction of the military situation in the Mediterranean area is well known to all and it also announced the US-EU commercial war with Italy that exports goods to the United States for over 36 billion euro.

Italy is running the risk to replicate the Greek disaster of the first government of Alexis Tsipras, which lasted the time of a budget six months after starting off with populist ambitions.
By the way, Tsipras today rules again, but he carries out a policy of rigor, with a heavy economic plan to reduce public debt through significant cuts in spending, transfers of public assets and new taxes.

Demata