The insurance requirement of Italian healthcare facilities exceeds 1,6 billion euros. This is the figure that emerged from the research carried out by Aiba (Italian Association of Insurance and Reinsurance Brokers) in partnership with the Department of Statistics of the La Sapienza University and presented today in Rome during the annual conference of AIBA "Public health and insurance: the proposal of brokers for the protection of citizens".
The analysis was performed on a sample of 126 hospital structures throughout the country divided between 32 individual hospitals and 18 ASLs which serve 94 structures. The fair value of the pure premium calculated without consider loadings: the average annual expenditure that the healthcare companies in the South should support for adequate insurance coverage is 1,7 million euros, while in the North the average value rises to 2,7 million euros. Carrying out a projection on the Italian health structures surveyed by the Ministry of Health, the Aiba research finds that the State should spend 1,6 billion euros a year to meet the insurance needs of healthcare companies. It is a question of defining which part of the risk must be insurable in order to find the right balance between the risk retained and the risk transferred to the insurance sector.
"The Italian insurance market – stated the president of AIBA Francesco G. Paparella at the beginning – does not present a wide range of this type of roofing: on the one hand for the absence of professional interlocutors capable of dealing with a risk characterized by low frequency but with a substantial economic impact; on the other hand due to the lack of a mathematical pricing model based on pertinent and robust methodological principles from the point of view of the statistical-actuarial approach”.
THE AIBA PROPOSAL
The solution proposed by AIBA aims at determine the part of risk which, due to frequency and average cost, could be financed by a contribution (fiscal or of other nature) on a national basis, constituting a first layer of public competence, managed by a National Solidarity Fund. A second tier would be left to private insurance companies operating in competition and without binding constraints. The risk management model split between public and private has already shown its potential in the agricultural risk insurance coverage sector where a methodology has been applied capable of promoting better knowledge of the risks, to the point of leading to a reduction in the share managed through public intervention.
THE TECHNICAL TABLE
By June 2012, Aiba's research will be made available to the institutions to create a technical table where the interested parties (Ministry of Health, Ministry of Economic Development, Ministry of Economy, Consap, Isvap, Ania, Anra and Aiba) will have the appropriate technical tools and data on real claims to be able to identify virtuous mechanisms that bring insurers back to offer the necessary guarantees to healthcare facilities.
"It is not true that there is a lack of data on this matter. There are various sources of information on the problem of risk management in hospitals and the riskiness of the medical profession". underlines Francesco Paparella. "The goal is to encourage data sharing to identify a viable solution which, in addition to restoring order to the sector, can offer real protection to citizens who are victims of seriously negligent behavior by the medical profession".
THE CONTEXT
There are approximately 34 complaints a year from citizens against doctors of health authorities for cases of medical malpractice. The causes of the increase in litigation between citizens and healthcare professionals are many: on the one hand, the increased awareness on the part of patients and the work of sensitizing associations in defense of patients' rights; on the other, jurisprudential evolution, lengthening of life expectancy, technological progress in diagnostic/therapeutic processes and the increase in treatable pathologies.
The insurance companies have gradually abandoned the sector of health structures, considered unprofitable, sending many public tenders deserted and in fact pushing hospital companies towards foreign companies with a single European license, very often lacking sufficient know-how.
Self-insurance is also on the rise. According to Aiba, the self-insurance formula should worry all citizens and institutions for the inevitable long-term social repercussions, taking into account the financial exposure to which public administrations are subjected in the absence of an insurance protection network. The social risk is evident: in the long run, citizens may not obtain timely and adequate compensation for the damage suffered. Damages which, moreover, are on the rise: the claims reported by local health authorities and doctors have grown by almost 300% in the last 15 years.
THE CONFERENCE
The Aiba conference was attended by exponents of the political and health world, heads of institutions, academics and insurers: Domenico Gramazio (Vice-President of the XII Permanent Commission on Hygiene and Health); Paolo Panarelli (General Manager of CONSAP); Paolo Garonna (General Manager of ANIA); Vasco Giannotti (President of the Safety in Health Foundation); Silvia Di Palo (Director of the Complex Legal Structure of the San Giovanni Battista University Hospital of Turin "La Molinette"); Paolo De Angelis (Full Professor of Insurance Technology and Finance at the “La Sapienza” University of Rome); David Morganti (Morganti & Associates Law Firm); Maurizio Castelli (Country Manager Italy XL Insurance); Francesco Avallone (Vice-President of Federconsumatori).
