Small steps towards supplementary healthcare

Politicians continue to squabble. Meanwhile, the public have already made up their minds. Or, to put it more accurately, they have been forced to do so. On the one hand, there are those who see every healthcare fund as a Trojan horse for privatisation. On the other are those who imagine that the second pillar alone can resolve the difficulties facing the National Health Service. Both positions risk missing the point. The draft resolution put forward by the Chair of the Senate Health Committee, Francesco Zaffini (FdI), seeks to address the reality of the situation, rather than being driven by ideology. Italians already spend around 70 billion euros a year on health and care. But almost all of this expenditure remains individual, fragmented and unplanned. Only a tiny fraction passes through funds and forms of collective intermediation. The question, then, is not whether the private sector should enter the healthcare system. It has already done so. The real question is whether the state should continue to ignore it or regulate it. Not an alternative to the National Health Service, but a second pillar that is explicitly complementary: more prevention, more long-term care, more transparency, more oversight and a broader range of beneficiaries – a system currently skewed in favour of employees and those on medium-to-high incomes, leaving pensioners and the most vulnerable groups on the sidelines.

The most interesting passage, however, is another. The document calls for an assessment of whether tax incentives for supplementary healthcare actually yield a greater social benefit than the use of the same resources to directly fund the National Health Service. At last, a reform that is willing to be judged by its results rather than by slogans. Then there is the political side of things. Zaffini is reaching out to the opposition, but warns that, if the debate remains bogged down due to filibustering, the majority is prepared to pass the resolution on its own as early as the beginning of next week. That would be a shame. Because the second pillar of the healthcare system can be reformed in many ways, but it is unlikely to survive if it continues to be held hostage by ideological caricatures.