Interview given to the magazine ‘Fortune Italia’ by the National President of Aiop, Barbara Cittadini, on the new price list for outpatient specialisation, which should come into force on 1 April 2024.
On this issue, the Minister of Health said that a ‘shared solution’ is being worked on, but what are the major critical issues with the new rates? Can we give some examples?
These prices, quite simply, are not remunerative of the costs incurred by the structures: a circumstance that affects both private and public hospitals, which – despite the rebates – will find themselves with increasingly precarious budgets. If we analyse the items that can be compared between the Balduzzi remunerations and the 2023 remunerations, more than 60% have a negative delta: this is the case, in particular, for instrumental diagnostics and laboratory services. It is a reduction in prices that, for services that are decreasing, leads to a fluctuation from 30% to 80%.
By way of example only, the fee for bronchial sampling during bronchoscopy is reduced by €116, while the fee for a single-site biopsy of the large intestine during a total colonoscopy is reduced by €57 (this is a 47% reduction on 2012).
Then there are the fees for specialist examinations, in respect of which reimbursement remains absolutely laughable: how can one think, with the fee of 22 euro, of being able to bear the costs of medical and nursing staff, as well as administrative, management and instrumental costs?
The real danger is that of having to interrupt the provision of services and benefits, reducing the protection guaranteed by the National Health Service and, at the same time, increasing waiting lists.
In the face of these reductions in remunerations, how have costs changed?
The new price list schedule does not take due account of essential aspects such as the technological innovation of equipment that has taken place over the last decade, in a national and international framework that, while still having to deal with the dramatic effects of inflation, is also suffering the economic consequences of the conflicts in the East, between Russia and Ukraine, and in the Middle East, between Israel and Palestine.
This, inevitably, is reflected – as we have observed in recent years – in increases in energy costs, as well as in the rising costs of consumables, equipment and reagents (by 30%-50%). Rates should have been increased, precisely because of the effect of the general increase in costs, but instead, in many cases, they were reduced.
But then what is the demand of private healthcare companies?
The hope is that the government will carry out a detailed analysis of the application of these prices and the consequent impact on the system. There are innovative services that must be guaranteed, in a fair and homogeneous manner, to the entire population throughout the national territory, without jeopardising the qualitative and quantitative standard of diagnoses, therapies and treatments that have been provided up to now.
Interview given by Barbara Cittadini on 1 March to the magazine Fortune Italia
