Healthcare is the illustrious victim of differentiated autonomy. There will be important repercussions on the territories in the coming years together with environmental criticalities. If it passes, in the end, it will penalize the same regions that supported it. Said like this, it may seem like a slogan to attack the promoters of the provision that bears the Minister's signature Roberto Calderoli. The distance that passes between local and differentiated autonomies is limited and among the 24 subjects that have been recognized to the Regions as a legislative power concurrent with the State, the right to health is the most compromised. The National Federation of Doctors and Dentists (FNOMCeO) have long sided against the bill which, meanwhile, was approved (by majority) by the State-Regions Conference. at protests that arise throughout Italy in the last few hours has been joined by that of theAssociation of Doctors for the Environment (ISDE-Italy), of Democratic Medicine, Active Citizenship, of Slow Medicine, of the Association of Doctors of Foreign Origin in Italy (AMSI).
"Differentiated" healthcare
Italian healthcare is already today different from place to place due to a long series of political errors or calculations. The attribution of further powers to the Regions can deal a definitive blow to the organization of medicine in the area. A path of no return is traced, they say five o'clock Associations. But let's go step by step. The current healthcare regionalism has in fact undermined the NHS as it was conceived by law 833 of 1978. pandemic it brought out all the limits of an organization that was - and needs to be - revised. After the emergency we accumulated waiting lists in public facilities up to 24 months for a mammogram, a CAT scan, an abdominal ultrasound. The problem is in the North as in the South, even if from Lazio down the situation is more serious. "The number of people who declare that they have had to pay for health services has increased: 41,8 percent declare that they have paid for specialist visits and 27,6 percent say that they have also paid for diagnostic tests," he explained Cristina Freguja, Director for social statistics and welfare, hearing in the Senate. On the contrary, a logical response to the damage caused by the pandemic "should have possibly been the return to a single and unitally governed National Health Service, not the acceleration of its disintegration through differentiated regionalism" says a note from the Associations. The Minister of the League is therefore reminded that differentiated regionalism will end up by normatively legitimizing the North and South divide.
The difficult health-environment relationship
A second level of alarm concerns the economic misalignment between the two Italys due to the different shares of the regional budget allocated to health care. According to the Associations, the discussion around the Essential Performance Levels (LEP) is rhetorical, which "still today must be precisely defined and, above all, adequately financed with resources to be found". What will happen in the relationship between differentiated healthcare and pathologies from environmental pollution ? How will it be possible to prevent the main climatic factors harmful to health? “These are factors that determine globally – as the World Health Organization informs us – about a quarter of pathologies in adults and even a third of those in children under five years of age” the doctors answer. Italy, obviously, is not out of these values, especially in large metropolitan areas.
Doctors on the run
And we are at the third degree of apprehension. In 2016, the national network system for the environmental Protection (SNPA). In the Regions it is necessary to implement the essential levels of technical environmental performance (LEPTA). The law also states that the qualitative and quantitative level of activity must be guaranteed in a homogeneous way on a national level. But the law - the doctors add - establishes that the LEPTA and the funding criteria for achieving the levels are established by decree of the President of the Council of Ministers. The beauty is that the "decree is still to come". And we come to the fourth degree of concern: the phenomenon of health care migration. All over Italy missing thousands of doctors and nurses. With the Northern League project of autonomy, with better working conditions and differences in remuneration, they will push doctors to leave the places where they are. "The situation is destined to worsen further when the gap between rich and Regions that are not rich, of the economic resources destined for health care”. More Italys with Harlequin-model healthcare.
