“There are still too many inequalities that characterize the right to health in our P.aese. Inequalities that various electoral programs presented by the parties on the occasion of the political elections intend to address mainly by putting their hand to a revision of the competences of the State and the Regions – on the one hand more centralism, on the other differentiated autonomy – which will inevitably take time, perhaps years. Time that patients’ rights can no longer wait. This is why it is necessary to act now and implement concrete measures that, in the short term, without necessarily ‘disturbing’ the Constitution, can counteract the inequalities that grip the right to health and the National Health Service “. Tonino Acetipresident of Salutequità, association for the evaluation of the quality of health policies, who spoke at the ‘State and Regions for equity in health’ event, organized by the same organization within the Health System Forum in Florence.
In his presentation, Aceti gives some examples of the differences in health care. “In Italy, life expectancy in 2021 was 82.4 years, but in the North we live on average 1 year and 7 months longer than in the South – he underlines – Also in 2021, in the face of a renunciation of care equal to about 11% at national level (in 2019 it was 6.3%), the differences between the regions are very significant: we go from 18% in Sardinia to 6% of the province of Bolzano “. But there is more.” 11.4% of hospitalized residents in the South – continues Aceti – went outside the region for medical reasons, against only 5.6% of residents in the North “.
On the side of health personnel, “Campania can count on 5.59 health workers per thousand inhabitants against 10.97 in Valle D’Aosta“, the president points out, observing that, on access to drugs,” in the face of a national decision by AIFA to authorize and reimburse a new drug for all citizens at the expense of the National Health Service, there are at least 7 Regions that have adopted its own binding regional therapeutic handbook which, in fact, represents a further step, slowing down access to the drug by the citizens who live there. If Covid-19 and the Pnrr have clarified the centrality of home care, in the face of a State-Regions Agreement on the standards for the authorization of the exercise and accreditation of home care signed over a year ago, about half of the Regions has yet to formally implement it “.
To ensure greater balance in care, Salutequità makes proposals. “Revision of the allocation criteria of the National Health Fund, focusing on the real health needs of the population and on the criterion of equity – specific Aceti – definition of the standards of health personnel to be guaranteed in all regions, of the standards of the regional health and social departments, but also implementation of the standards of territorial assistance in the regions “, and” relaunch, implementation and stringent monitoring of the National Chronicity Plan and National Plan for Government Waiting Lists “.
At the bureaucratic level, Aceti’s suggestion is to “repeal the binding regional therapeutic handbooks, rethink the instruments of the repayment plan and commissioner, approve the ‘Tariff Decree’ to implement the New essential levels of assistance (Lea) launched in 2017“. In this regard, the president of Salutequità proposes to proceed with the” definition and approval of the essential levels of social benefits and the strengthening, modernization and implementation of the New Lea guarantee system, that is the monitoring and evaluation system of the central level with respect to to the ability of the Regions to guarantee services and the right to health for citizens, which is currently highly inadequate “.