One reader tells us: “Unable to find an explanation for my changing blood readings, the oncologist hesitantly prescribed me a series of tumor markers. I then contacted my family doctor for a prescription, but he refused to give it. He says that they are too expensive according to the national health service, that markers are not always reliable in making a diagnosis, and that if I really want to have these tests done, I can go to a private laboratory. Should I trust the specialist or the family doctor? But I did everything privately; It cost me 80 euros.”

At first glance, 80 euros is not a lot from a public health perspective compared to the consequences of not detecting cancer early. And also with economic costs: hospitalization and stay in the hospital, any surgeries, cycles of chemotherapy. In the end, the national healthcare system will spend tens of thousands of euros.

Prevention at risk due to long waits

Of course, prevention is always better than cure. Also for the wallet. However, as waiting lists got out of control and public budgets gradually entered a crisis, the State assigned the role of guardian of the fund to each doctor: From this perspective, are today’s health measures above or below our country’s economic means?

If we consider the health status of Italians by age group, the answer is quite sensitive. The population over the age of 65 actually makes up 23.8 percent of the total; half are over 75 years old. An ever-growing share, according to estimates, which will reach 34.9 percent of residents in 2050. Since the elderly are also the most vulnerable segment of the population and most exposed to diseases and disabilities, any changes in the availability and timing of services can have serious consequences. Daniele Tempera’s research on Today.it confirms this: “When we call patients on the waiting list, they are often already dead,” admits a cardiologist.

Regions such as Lombardy limit the prescribing of tests and medications based on national and local indications. The best training schools for future general practitioners are very insistent on the implementation of the rules, but this has not been decided by the current government of Giorgia Meloni. In fact, they date back to the State-Regions agreement of July 2, 2015, when the then government of Matteo Renzi set initial targets to make health spending and the availability of prescriptions more efficient. “Apart from the terms of supply – guidelines that have since been established – services remain the sole responsibility of the patient.”

Salary penalty for wrong prescriptions

Doctors who fail to comply are putting themselves at out-of-pocket risk: “The doctor is required to include these indications in the prescription when prescribing as stated by law, and the National Health Service prescription book should not be used for specialist service prescriptions unless specified conditions exist.” : Under the penalty of applying for financial reduction after the reasons are determined by the institution. […]”.

It all depends on the control effectiveness in individual recipes. But the most productive regions are also likely to be the most violent. And while today the government forecasts one billion 788 million less for 2024 compared to the 2023 health budget (1.32 percent cut), it is equally likely that the checks on doctors to earn our living will increase.

Patients and stress, family doctor’s advice

Filippo Viganò spent his life as a family doctor in a town in Lombardy. Although he could have retired during the most difficult months of the Covid epidemic, he is among the GPs who gave up so as not to let down many elderly patients. Later, he also had to get permission.

“This bureaucratic approach makes the GP’s job extremely difficult and robs him of the time needed to establish an adequate caring relationship with the patient,” Viganò explains to Today.it. “It creates prescribing anxiety and can lead to conflicts with patients who may not know the endless rules that guide prescriptions. Convenience is one thing.” : that is, the right test at the right time for the right patient, and this should be the rule for every prescriber. The constraints of controlling expenses or meeting targets to reduce waiting lists are one thing. More staff will be needed for this. But that is another a story.”

So they spent 10 months of health on Superbonus

So, in addition to endless waiting times, let’s prepare ourselves for the refusal of tests and visits, even if prescribed by a specialist. Just like what happened to our reader. If it is really difficult to accept the fact that the ideal healthcare we want no longer exists, let’s get used to observing the facades of buildings: Since the last government of Giuseppe Conte, Italy has spent $109 billion on building costs (Giancarlo Giorgetti, Minister of Economy, September 2023) which has now become public debt. A benefit fueled by the inevitable increase in material and company prices, which affects only 3.5 percent of residential buildings. We will spend approximately $133 billion on healthcare since 2024; At the cost of the Superbonus we could treat every Italian from January to October.

Continue reading on Today.it…