We’ve all heard the fables of the mediterranean diet and all its virtues. Italian villages with the liveliest octogenarians you’ve seen this side of a Bertolli Olive oil commercial! You may be surprised to hear that there may be more to it than you think.
In the WHO Healthcare Systems Ranking of 2000 Italy actually ranked in 2nd behind France.
Now given the economic turmoil and contagion sweeping through Europe you really have to put these rankings in some perspective and 2012 doesn’t necessarily reflect the findings of 2000. However, since the system does remain unchanged and the quality of care (as far as I can research) remains relatively stable then it should be worth some analysis.
Right, let’s get started.
First thing’s first. Italy does in fact has a National Health Service not to dissimilar to that of the UK’s. This of course means that it is funded by the public purse through taxation. Again, healthcare is affordable and accessible and in most cases the government foots the bill aside from a minimal co-pay when it comes to medications. As in the UK, the service is co-ordinated through a series of localised health authorities.
As you can imagine, since it’s so similar to the NHS in the UK, it suffers from similar problems. For example, extensive waiting times and some hospitals which, to be quite honest, are substandard for a developed world nation. So that leaves many Italians to seek alternatives, either travel a considerable distance to be treated regularly at an institution with reduced waiting times or go private.
An interesting point about Italy is that it can be an example of how decentralisation can allow healthcare to excel as long as it’s incentivised. It was in 1997 when decentralisation occurred giving local authorities greater independence to set standards and administer reimbursements to public hospitals.
Specifically, the Lombardy region defined it’s owned standards and allowed both private and public sector institutions to compete for funding as long as they both provide affordable, quality care.
Everyone upped their game. Private institutions offered a wider range of services whilst public hospitals upped the quality and accessibility to care. Lombardy now has enviably minimal waiting times and one of the widest ranges of accessible treatments and medications for their populace. So much so that many travel across Italy to receive healthcare through funding from their home authority. It’s a win-win since Lombardy gains a greater market for reimbursements and due to their lower cost spend per capita allow other authorities to save financially.
So, my point.
Government can actively defines the rules of the game.
We worry about profit incentives affecting healthcare? Then make quality of care the sole way of achieving profitability.
We worry about the private sector but why does it matter as long as the care is affordable and the best quality available? As we have seen previously it’s completely possible to create public insurance systems in which private organisations can operate. Competition can breed quality.
Universal Care. Choice. Accessibility.
Those should be the central features of any healthcare system.
Private vs Public? It doesn’t have to matter. We can have the best of both! It just needs a bit of planning…
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Dr Saif F Abed
AbedGraham Healthcare Strategies Ltd