In the aftermath of Prime Minister Mario Monti's speech on the "sustainability risk" of the future National Health System, Sergio Corbello, President of Assoprevidenza, observes that in order to maintain the inalienable right to health, "Public health has an absolute need for complementary assistance. In this perspective, a new "integrated" welfare model should be rapidly launched, with the convergence within a single legal entity of supplementary pension benefits, supplementary health care and coverage of risks linked to incapacity, often dependent on aging, through a widespread offer of Long Term Care coverage”.
Called to reduce the debt, it is in fact unthinkable that Italy can increase the incidence on social spending which today represents around 30% of the Italian GDP. A value in line with other European countries, but the demand for resources to finance healthcare, assistance, work and support for families is growing sharply due to the constant increase in life expectancy: about two thirds of people over 75 years of age must resort to informal assistance, mainly provided by carers or the closest family members and in particular by women.
Italy is one of the oldest countries in the world: in 2011 there were 144,5 elderly people for every 100 young people. A ratio which, according to Istat estimates, will rise to 2030 elderly people out of 205,3 young people in 100. The aging of the population will lead to an increase in the demand for healthcare which is already struggling to find an answer for everyone: in the last year over 2,4 million people were unable to access healthcare services for "economic reasons" (source: census).
Despite the presence of the National Health System, the private health expenditure component is particularly significant today (over 30 billion euros, equal to about 23% of the total) and is largely supported directly by citizens (82%), while the 13,9% is channeled by supplementary health funds and 3,7% by private health and life insurance.
According to Sergio Corbello, the weight of health care costs borne by Italian families is somewhat unfair “since it falls on the families who have to assist a sick person, with clear disparities between those who have sufficient financial resources for treatment and those who do not. It seems clear that the current welfare system is destined to undergo a genetic mutation. Certainly, to maintain the universality of the system, if it is not possible to reduce the percentage of private expenditure, it will be necessary to "requalify" it, moving from the concept of individual expenditure to that of collective expenditure with shares of mutuality and solidarity. The collective forms of complementary assistance are precisely the most suitable tool, perhaps in combination with social security, to respond to the need for long-term assistance and to guarantee the technical sustainability of the system".
The constraint imposed on health funds to insert a minimum quota of resources intended for services exclusively supplementary to the NHS (social-health and/or dental) in the amount of at least 20% of the total, represents a first attempt by the Legislator to direct complementary health towards integration into the public service.
