That there is a crisis in Italy is certainly nothing new, that the state accounts do not shine for virtuosity is even less so and that it is public health that suffers first is certainly not surprising. In 2015, the repayment plans and the spending review implemented a maneuver worth approximately 2,3 billion euros. Costs for goods and services and for medical devices were affected by approximately 1,5 billion euro, pharmaceutical expenditure by more than 500 million and, moreover, a weakening of "inappropriate" services for specialist, outpatient and for rehabilitation admissions.
It is a pity that the cuts in public health expenditure do not go hand in hand with the needs of citizens, 9 million of whom declare that they are unable to access the health services they need, due to their economic conditions. To this must be added the change in the Italian corporate structure, which sees a progressive increase in the over 65 year old population (ISTAT has estimated that there will be around 3,5 million in 2030) which typically represents individuals with a weak economic strength and with substantial and ever-growing health needs.
How to take cover? The term still not widespread in the Italian system is "company welfare" or the use of forms of remuneration for workers, alternatives to the traditional ones. Instead of wage increases, companies can provide their employees with health insurance coverage so as to support both the public system and citizens who are unable to meet their health needs with private spending.
The United States and the United Kingdom are among the most advanced countries in the use of "corporate welfare" mechanisms, while Italy is still weak. Citizens, in fact, have always been able to count on "public welfare" and then we must not forget the peculiarity of the Italian labor market, made up of about 85% of SMEs which very often have neither the knowledge nor the managerial strength to be able promote and encourage changes, especially in remuneration policies.
Although Italy is not at the forefront, however, weak mechanisms are nonetheless in place to stimulate the initiation of a change in the relationship between citizens and health care. Many CCNLs oblige companies to provide health coverage to workers (which, however, to date, is minimal and insufficient compared to real needs). Furthermore, Italian legislation provides for considerable tax benefits for companies that implement "corporate welfare" policies for their employees.
For the Italian market, it becomes essential to understand and fit into the "corporate welfare" forms of pay. This is all the more true when one considers that it is not only a matter of compensating a weak public system and meeting the needs of workers, but, in an ever smaller world, in which workers are increasingly inclined to leave the country, the the Italian market must also be competitive thanks to remuneration policies that can compete with those offered by the foreign market.
