An ISTAT survey on the number of Italians that forego medical care due to a lack of funds for treatment has been reduced from the previously published number of 12-13 million to less than 4 million. These numbers refer only to public healthcare. Other data reveals, more generally speaking, the difficulties facing the National Health Service… more and more citizens are seeking private healthcare.
On the occasion of the WHO’s World Health Day, Eurostat disseminated data on the difficulty of accessing treatment in Europe. The Eurostat analysis is the last in a series of surveys that raised the problem. In particular, in Italy, a Censis/Rbm survey indicated that 12.2 million Italians would have given up on or delayed health funds for treatment due to economic reasons. But is this really the case?
We would like to answer this question by referring to the part of the Ehis Survey (European Health Interview Survey)- conducted by ISTAT- that exclusively regards Italy and its National Health System. We would like to emphasize that this is not the same data used in the Eurostat survey, which also takes private healthcare into consideration, but does not distinguish between the two types of healthcare, while ISTAT focuses on the perception of citizens with respect to the availability of public healthcare.
Official ISTAT data clearly reveals that the situation in Italy is less serious than what it appears. In fact, an average of 12% of Italians (approximately 6 million) forego at least one medical treatment for different reasons, but not only for economic reasons. Thus, foregoing a single treatment does not mean foregoing treatments in general and/or not having enough funds for treatment.
By analyzing, instead, the number of people that forego treatment due to a lack of funds, the percentage is reduced to an average of 7% (3.6 million people). An average of 4.4% of the population (2.3 million people), instead, forewent the purchase of prescribed medication.
Long waiting periods and higher costs
Even if there are less Italians foregoing public health services than previously thought, many do prefer private healthcare. One of the reasons for this is due to the deterioration of services offered by the National Healthcare System. According to a study presented by Crea Sanità, the waiting period for an appointment with a specialist has increased by 27 days in the last 3 years, often creating even a three-month wait. The waiting period for exam results has increased as well. For example, the delivery of hand x-rays has increased from 3 days to 22 days while the results of a colonoscopy have increased from 10 days to 96 days. Another reason Italians are turning more towards private healthcare facilities is because even the cost of the co-pay fee has significantly increased. The difference between an invoice in a private facility and the hospital co-pay fee is often only €10-20.
Loans for people who cannot afford treatments
Another interesting fact has emerged from statistics published regarding the population and healthcare. The number of Italians that asked banks or credit institutions for various types of medical loans and financing in 2017 has increased, totaling 400 million euros in requested loans. This data was processed from a sample of 50,000 loan and financing requests presented from January to December 2017, which confirmed a tendency that was already forming in previous years.
French and German examples
It may be useful to think beyond national horizons in order to solve the problems facing the National Healthcare System. France and Germany provide two models:
– The “French” Second Pillar Healthcare Model is not a model by which citizens receive private health care, but a system of financing in addition to the National Healthcare System that allows for the mediation of the health costs (including the public healthcare co-pay fee) that citizens must pay. This would guarantee an extra 22 million euros per year for the public health system and the containment of private health costs from 8.7 million euros to 4.3 million per year.
– The outsourcing of some types of health care (the German model) to promote the accountability of citizens with higher incomes by offering private insurance that covers the total cost of healthcare, thus reducing public healthcare from 18.5 million euros to 3.1 million per year that can be invested towards the healthcare costs of more needy citizens.
Even if these are not the most suitable solutions for National Health Services in Italy, a solution needs to be found soon given that the number of patients that forego public health care is constantly rising.
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