“No one wants cuts to health care but no one wants to waste.” And ‘this a first comment to the Palazzo Chigi tough stance came from the Conference of Regions on the assumption circulated in these days of a new spending review from 3 billion to the NHS. A clarification in the middle that still leaves unanswered. Whether it’s cuts or fight against waste, in fact, the source from which to draw is likely to be the same: the National Health Fund (FSN) for the regions. A sword of Damocles over the heads of rulers, ready to make the wall.
In front of the Palazzo Chigi denial of the reports in the press, the president of the Conference of Regions, Sergio Chiamparino, confirms the position taken in the morning: “I note with satisfaction but I want to clarify – he added – that is one thing if you say that you have to save in health care through the reorganization and modernization, and we are committed to this by signing the pact on health. If you want to reduce the health fund, then this incontrebbe our opposition. “
At stake is precisely the Pact for Health 2014-16, that with the suggested cut from 3 billion to FSN risk jumping. This event Chiamparino was pronounced bluntly this morning: “With the Government in August, we signed a pact of honor on health: if it breaks there is less trust and cooperation. The Pact for health – he said – he committed, up to December 31, to write plans of reorganization of health services and has provided a fund of 109 billion euro, an increase of about 2.5 billion more l ‘ year, for 2015 and 2016 to fund the NHS. “
Chiamparino has also made it known that he had written a letter to the Minister of Health, Beatrice Lorenzin, who were asked to keep the money and commitments agreed upon and have been activated for a confrontation with the government.
The governor of the Veneto, Luca Zaia, there is a real threat and revolt . «Audition to cut a single euro to health Venetian – promises – and I will personally spread across the road they want to travel to the destruction of health in Italy, particularly where, as in Veneto, every euro risparmiabile has already been saved without waiting for geeks turn. Here we further reduce spending would inevitably cut support for users. We think well, before it can set in motion a real revolt. ” A tough position, and insists, “with no room for negotiation.”
Addressing the Chairman of the Board Matteo Renzi, Zaia announces the sending of a table “so clear that if you only have the goodness of study, will make him understand why many of our total, dry, no unchangeable. And we may be permitted to doubt seriously sull’ennesima promise that the cuts will not be linear. In fact, so far – pursues Zaia – the ax has fallen on healthcare in a completely non-selective, affecting first of all those who have already rationalized. ”
“The wicked little game is finished – adds Zaia – why implement a cut in certain territories is as easy as drinking a glass of water; do it over here would easily imaginable consequences: cutting services to the people, because here the fat that drips and waste them and we liminati time. The Government wants to reduce the Italian health system, like many others in the world where before they ask you to measure the pressure of the credit card? There is succeeding perfectly, but presenting a very high regard for citizens: the loss of the constitutional right to health. “
Speakers also the President of the Campania, Stefano Caldoro vice chairman of the Conference of the Regions:” I want to say on health only one thing: in the latter period with the government we have reached important agreements. Now pacts must be respected. ” The likelihood of further cuts in health care spending review contained in the transaction on which the Government is working, Caldoro stressed that “this does not mean that we are not prepared to deal with all the talk and the commitments that we made on efficiency.”
And by Enrico Rossi, he was invited to fish from the ‘golden pensions. ” “You do not have to cut health – Governor Enrico Rossi said in a post on facebook – which has already given much to the restoration of the country and that is the only sector in which we spend on average in Europe to have better services to who spends most of us. If you need to find resources is good to look for them in the inn over three thousand euro, a figure high and more than enough to live on, especially in a country where health care is public for all. Solidarity – argues Rossi – do not cut and to do justice in difficult times you ask those who have more to contribute. “
Cut unsustainable for the Lombardia. “A cut in funds for health care would mean a reduction in services and the risk of rising ticket. There is no alternative. ” To explain it was Massimo Garavaglia, councilor to the financial statements of Lombardy and coordinator of regional councilors Financial Affairs at the end of the Conference of the Regions. “But it would be mainly a defeat for the government – added Garavaglia – which announced it had secured the accounts of health.”
To the President of Lazio, Nicola Zingaretti, further cuts would be a disaster. “I hope that does not correspond to the truth to the rumors about cuts to health care – said the governor of Lazio – because otherwise it would be a disaster of untold proportions for our lives. In July we signed the pact on health, which is a pact of honor, as he said Chiamparino, a point of innovation in health care and you can not put it back after forty days in question. The words of President Chiamparino were clear and correct. Obviously, great willingness and commitment to reducing waste in health care. For this reason, in July we signed a pact that, through innovation, has this objective. On the basis of this agreement have been defined budget, we live in
the application phase of this program and it is not possible to take into account, after a few weeks, the idea of tearing or cast doubt on that pact. Fortunately, it seems to me that at this time there have been questions that I hope will be confirmed by the concrete behavior of the government. “
Net’s comment Liguria : “The Government must not touch the health and must do what is written in the covenant for the health that has been agreed between the State and the regions.” The Vice President of the Region of Liguria and commissioner for health Claudio Montaldo rejects the Government’s proposal to cut funding to health care. “All regions are opposed – says Montaldo – because we just signed the pact on health between the Government and the Regions which provides a framework of well-defined resources, both for 2015 and for 2016, not random, but to ensure the functional coverage new basic levels of care and new drugs that are vital for a large number of people. Waive such funding does not mean fat health food, but not to fund services required for citizens. ”
The commissioner of health Liguria is said also “opposed to any maneuver sharing because it would hit the low and middle-income citizens who are already suffering the effects of the crisis and also deprive resources to the development of consumption.” Montaldo invites the Government and the Prime Minister to refer to the Health Pact, “which contains a number of agreed measures to save money on goods and services without affecting the performance, providing the concentration of purchases, both at regional and supra regional, and ‘further reorganization of the system in the sign of appropriateness. Only on this region is ready to accept the challenge. ”
According to the former Minister Renato Balduzzi, margins to rationalize spending there are . “Supply of goods and services, reference prices, balance between hospital spending and territorial: these are the main areas – says Balduzzi – where you can make operations rationalization of health expenditure, without compromising services. Areas which have already been identified by the Monti government’s spending review. ”
“You have to get out of the logic of the cuts – continues the former minister – it is not necessary to rationalize and reduce spending.” According Balduzzi, in fact, “the linear cuts are an alibi for the regions not virtuous. And the overhaul of health care spending in 2012 – concluded Balduzzi – it was not made up of linear cuts, but rather gave instruments to intervene in critical areas. “
E for another former Health Minister Girolamo Sirchia, would “reset a drug policy more careful,” . “The doctors, of course not all, but in general – precise – prescribe too much, putting the recipe in the oddest products that often have very limited effectiveness. They should therefore be involved in cutting this waste should be reviewed and the therapeutic handbook, changing the basis on which to fix rods. Just to politics ‘molecules equal prices equal’. Enough with the ‘me too’, almost medicinal ‘copy’ of other already available. It should reward real innovation and redesign clinical trials with this goal. “
CGIL:” With new cuts do not ensure the Lea “. Alarm by the CGIL: “Add 30 billion in cuts already made in recent years on health care an additional 3% is absolutely unsustainable. A choice of this type is equivalent to the decision not to insure the most essential levels of care, as is already the case in some regions. “They said Vera Lamonica, confederal secretary of the CGIL and Stefano Cecconi, policy officer of Health Corso d ‘ Italy.
“As stated by the Conference of the Regions – continued union leaders – an intervention of such proportions that the zeros of the Health Agreement signed in early August.” Moreover, the unconvincing ‘ ambiguous answer to Palazzo Chigi, “the denial of the executive is not exactly a denial – say Lamonica and Cecconi – so reassures us all. Wastage and inefficiencies are often the result of corruption and misrule – still – and should be fought with decision. resources so recovered must be returned to the people, with more services and less ticket. These are the reasons why the CGIL has launched a mobilization campaign “Save the Salute,” which began in recent days. A campaign that runs through Italy with the aim of putting an end to the season of the cuts and revive the system of social welfare and public health and universal. “
Acoi: “Involve operators in cutting wastage.” “The fight against waste is a necessity to ensure good public health, compliance with the standards of quality and safety performance, but to really cut waste without undermining the foundations of health service to the citizens need to be involved in the reorganization of all the operators who work every day with sacrifices and difficulties. “says Diego
The Piazza, president of the Association of Italian Hospital Surgeons.
“To date, public health spending – continues Piazza – is much lower than the European average, but we are available to discuss the cuts, does not frighten us. What is not acceptable is the absence of a defined path and the goals that lead to undertake it. ” With the economic resources available, and with a system with decentralized shopping centers, which are the services that can be provided to citizens by public health? The risk is to no longer have the means to meet the needs of patients. An example: In Sicily in twelve centers that have initiated procedures for the heterologous fertilization only one belongs to the public health service, while the other eleven are private. “
” If you want to move health actors to the private sector – concludes the Acoi – and you want to subcontract a slice of the healthcare system, the government must have the courage to say it. “
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