“The Bill on the 2025 Budget is very far from the needs of public health: the resources allocated are not enough to revive a National Health Service (NHS) in serious trouble. They are largely insufficient to finance all the measures envisaged by the Budget and are missing from the appeal for priorities relevant to the maintenance of public health”. These are the main critical issues that emerged from the Gimbe Foundation’s hearing at the joint Budget Commissions of the House and Senate, where President Nino Cartabellotta called not to use healthcare as a political battleground and put forward concrete proposals for the refinancing of the National Health Fund .
For Cartabellotta “the reduction in investments in healthcare compared to the wealth produced by the country clearly emerges, a sign that the strengthening of the NHS and the protection of health are not a priority even for the current Government”. In fact, in terms of percentage of GDP, the FSN drops from 6.12% in 2024 to 6.05% in 2025 and 2026, and then falls to 5.9% in 2027, 5.8% in 2028 and 5 .7% in 2029. “This trend – he observed – reflects the continuous disinvestment from public health, started in 2012 and perpetrated by all Governments. The progressive increase of the FSN in absolute value, increasingly heralded as a great achievement, is in reality a mere illusion: because the share of GDP allocated to healthcare is inexorably decreasing, except for the years of the pandemic when extraordinary funding for emergency management and the decline in GDP in 2020 masked the problem 2025 will even fall below the psychological threshold of 6%, reaching an all-time low.”
Measures and resources
From the detailed analysis of the planned measures, a clear gap emerges with the resources allocated. In the period 2025-2030, the overall cost of the measures amounts to 21,365 million, to which must be added the contractual renewals of healthcare personnel, not reported in the text of the Budget. Costs that the Gimbe Foundation has estimated at 7,649 million: 3,618 million for the three-year period 2025-2027 and 4,031 million for 2028-2030. “Calculator in hand – explains Cartabellotta – the measures envisaged by the Budget for the period 2025-2030 have an overall impact of over 29 billion, while the resources allocated amount to approximately 10.2 billion. With a gap of almost 19 billion and a The NHS is already in serious trouble, it is obvious that even the most virtuous Regions will struggle to implement the measures set out in the Budget and will have to cut services and/or increase regional taxes”.
“Crucial priorities for the maintenance of the NHS remain excluded from the 2025 budget – noted Cartabellotta. First of all, the extraordinary plan for hiring doctors and nurses, the abolition of the spending cap for personnel and adequate resources to restore attractiveness to the NHS, given that the specific allowances are only crumbs. Furthermore, there is a lack of resources to reduce/abolish the payback on medical devices and to manage the continuous exceeding of the direct pharmaceutical spending ceiling, which is weighing more and more on the pharmaceutical industry”. Finally, even the ‘new’ LEAs for specialist and prosthetic services, expected for 8 years, risk being postponed beyond 1 January 2025, due to the scarcity of the resources allocated.
Gimbe proposals to refinance the NHS
Following the political options suggested by the OECD report of January 2024, the Gimbe Foundation presented concrete proposals at the hearing to refinance the NHS. “In the impossibility of increasing total public spending given the unlikely leap in GDP in the short-medium term and the EU constraints on debt, it is necessary to focus on the combination of the other strategies proposed by the OECD. First of all, increase resources for healthcare – he indicates Gimbe – reallocating them from other chapters of public spending and/or introducing specific taxes, in particular on products that damage health (‘sin taxes’): cigarettes, alcohol, gambling, drinks and sugary products, and/or taxing millionaire incomes and/or extra profits of multinationals”.
“Secondly – the Gimbe proposals continue – reevaluate the boundaries between public spending and private spending: after effectively updating the essential levels of assistance (the services that the NHS is required to provide to all people, free of charge or upon payment of copays) , it is necessary to implement a ‘healthy reform’ of supplementary healthcare that allows health needs to be covered by increasing intermediated spending and reducing that paid by citizens (out-of-pocket); review the sharing of healthcare spending; of national governance, public-private partnerships. Finally, implement a national plan for disinvestment from waste and inefficiencies to increase the value of health spending”.
“It is now time to roll up our sleeves – concluded Cartabellotta – abandoning both the populist proclamations of the Government and the unrealistic proposals for refinancing the opposition forces, avoiding making healthcare a political battlefield. Because without an adequate strengthening of the NHS with adequate resources and courageous system reforms, we will only have to helplessly watch its decline: we will see its function of universal health protection dissolve, disregarding the principle enshrined in Article 32 of the Constitution. Consequently, it is essential to rethink the allocation policies of country to counter the progressive demotivation and flight of healthcare personnel from the NHS, the difficulties in accessing pharmacological and technological innovations, the inequalities in access to healthcare services and benefits, the increase in private spending and the renunciation of treatment. Otherwise, we will say definitively farewell to universalism, equality and fairness, founding principles of the NHS”.
The reactions
The reactions from the opposition were immediate. “Giorgia Meloni stop, stop arguing with calculators, because we have all seen that the numbers don’t add up”, says the secretary of the Democratic Party, Elly Schlein, in a note.
“If you don’t want to listen to our requests on public health, at least listen to the cry of alarm that Gimbe is launching today on the financing of the NHS and listen to the health workers who are now exhausted and who work in contact with citizens every day. Already in 2027 Gimbe foresees an expenditure in relation to GDP below 6%, for a total shortfall of 19 billion. We had already understood that the plan of this right was to encourage private healthcare, their private healthcare, such as the clinics of the undersecretary of their government. Gemmato. But here we are beyond all limits: giving this coup de grâce to the national health service means dismantling it.”
“So, instead of continuing to throw taxpayers’ money into the already failing Albania model, put the necessary resources to save the NHS. You owe it to the Italian citizens whose right to health is enshrined in the Constitution, on which you swore” , concludes Schlein.
“On healthcare we are faced with a national emergency but it’s time that the Meloni government didn’t understand it, as emerged on TV, where it was clearly having difficulty dealing with the accounts”, wrote the leader of the 5 Star Movement, Giuseppe, on Facebook. Count. “The Gimbe Foundation did the calculations today in Parliament: in the planning of the Maneuver – continues the M5S president – 19 billion are missing to guarantee the planned measures, the ratio between the Health Fund and the GDP will reach the ‘historic minimum’ in 2027, below 6%, the Regions will have to cut services or increase taxes. While the Minister for Health of the Meloni Government announces 10 thousand hirings of Indian nurses, thousands of our underpaid nurses are going abroad and, as Gimbe reminds us, in the 2025 budget. what is missing is the extraordinary plan for hiring doctors and nurses, the abolition of the spending cap for personnel, while there are only crumbs for specific allowances for healthcare personnel”.
For Conte, therefore, “a shock therapy is needed, a U-turn on which all citizens must appeal to this Government: 39 billion and +7.5 billion in 3 years on armaments are not needed, rather we need to tax extra profits collected by the arms industry during the war. Let’s take the resources from the arms race to focus them on healthcare, emergency rooms, waiting lists, salaries and allowances of doctors and nurses. The real trenches of the country – he concludes -. is this: the right to health is code red.”
For Angelo Bonelli, national spokesperson for Green Europe and member of Avs, “the data presented by the Gimbe Foundation speak clearly and lay bare the disaster implemented by the Meloni government: by 2027, funding for our healthcare system will fall to 5% 9% of GDP, the lowest level ever, while by 2030 we will accumulate a hole of 19 billion.”
“The right has chosen to abandon the NHS, leaving it in agony to favor the private sector and the interests of a few, including those who have direct links with private healthcare, such as Undersecretary Gemmato. This government is giving the final blow to our system healthcare leaving millions of citizens without adequate care. While Prime Minister Meloni goes on television to present fictitious and improvised data, the reality is there for all to see: the government’s attack is a deliberate attack on the fundamental rights enshrined in the Constitution in these two years government, banks, energy and pharmaceutical companies, as well as military industries, have accumulated profits of over 100 billion euros. Yet, the government does not want to tax this enormous wealth.”
“On the contrary, it continues to cut essential funds for health, the environment, public transport, schools and social services. Why not allocate the funds foreseen for the Bridge over the Strait of Messina (14 billion euros), a useless and propaganda wanted by Salvini, to the national health service? It would be a common sense choice, but this government is totally uninterested in reducing territorial and social inequalities”.
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Well, well, well! It seems that our beloved National Health Service (NHS) has been put on a bit of a diet, and folks, it’s not a healthy glow-up—it’s a slow and painful starvation! Let’s dive into this budget shambles like it’s a wobbly table at your aunt’s holiday dinner!
So, the head honcho of the Gimbe Foundation, Nino Cartabellotta, has made it clear that the allocation for healthcare in the upcoming 2025 budget is about as nourishing as a stale cracker. He’s waving the red flag, shouting, “Hey! We’re in trouble here!” And he’s not just being dramatic like one of those soap operas where everyone loses their minds at the prospect of a forgotten anniversary. No, this is serious!
The Numbers Game
He argues, rather convincingly I might add, that the cuts being made aren’t just slicing a bit of the fat but are aiming straight for the muscle—well, for the NHS, anyway. The percentage of GDP allocated to the NHS is going to drop from 6.12% to 5.7% over the next few years, and the last time anyone saw numbers like these, they were on a bad stock market day! The panic is palpable, folks! By 2027, we’re set to hit a record low under that mystical 6% threshold, which is like asking your favorite dog to win a race when it’s just been plopped in a bath full of puppy shampoo. Spoiler alert: it’s not gonna happen.
The Budget Blues
Now, let’s talk about what the budget actually lays out. We’re apparently about to shell out a cool 21 billion for various measures but what’s that? There’s a blooming gap of 19 billion between what’s needed and what’s being actually allocated! Calculator tucked away, the regions are likely going to be scrambling to either cut services or dig deeper into their pockets. I mean, we’re talking about a healthcare system that’s already gasping for breath like a fish out of water. Perhaps they could just put a nice sign on the NHS saying, “Closed for Business” until further notice, eh?
Yet, here we are, looking at proposals that, if implemented, could actually salvage the NHS. Cartabellotta suggests slapping a few “sin taxes” on sugary drinks and cigarettes. Why not, right? Let’s tax all the things that love to ruin our health (but never our good times). If only they could slap a tax on politicians’ lack of common sense while they’re at it!
The Opposition’s Outcry
Meanwhile, the opposition is batting their eyelashes and waving their hands about with a certain flair reminiscent of a dramatic stage performance. Elly Schlein, the glamorous secretary of the Democratic Party, shouted out that Meloni should stop miscalculating everything and listen up! The numbers aren’t quite adding up, which hopefully means they’re not taking their “math” lessons from me—unless they’re keen on jokes and puns!
Conte, from the 5 Star Movement, has joined the choir, strumming the strings of urgency as he proclaims hefty changes are needed right now! Taxes for arms, not hospitals, is his battle cry—because let’s be honest, who thought we’d ever face a scenario where our healthcare was treated like some last-minute school project?
To Sum it All Up
So, here we stand, a nation teetering on the edge of health crisis—not because we can’t take care of our citizens but because our leaders seem more interested in their political squabbles than the healthcare of millions. If they spent half as much energy on healthcare reform as they did debating who gets to wear the crown at political parties, we might actually see some progress worth cheering for!
Honestly, strap in, folks, because the way things are going, we’ll soon be witnessing healthcare debates becoming as common as reality TV stars on our screens. So let’s hope they find a balance—because nobody wants a healthcare system modeled on a budget designed for a circus act!
Roll on 2025, brace yourselves for the budget circus! 🎪
Ngs that are unhealthy and use that revenue to shore up our crumbling National Health Service. After all, if there’s one thing that can cheer up a budget shortfall, it’s a tax on the stuff that gives us a sugar rush or a nicotine buzz!
Rethinking Spending
The Gimbe Foundation’s proposals push for a deeper reconsideration of public versus private spending in healthcare. Instead of shuffling around the same tired dollars, how about we rethink our entire approach? We could update the essential levels of assistance the NHS is required to provide and craft a supplementary healthcare system that minimizes out-of-pocket expenses for citizens. It’s about making healthcare more accessible while simultaneously tackling waste and inefficiency. Sounds like a win-win, right?
A Call to Action
Cartabellotta’s urgency couldn’t be clearer: we need to stop playing politics with health and start rolling up our sleeves. Unless we give the NHS the resources and reforms it so desperately needs, we’ll be watching its essential functions deteriorate before our very eyes. Can we afford to let this happen? Certainly not!
The Opposition Reacts
And speaking of all this drama, the opposition isn’t sitting idly by, either! Elly Schlein of the Democratic Party is hitting hard, claiming the government is drowning in mathematical miscalculations. She’s calling for more funding to save the NHS rather than allowing it to wither on the vine while cozying up to private healthcare interests. Meanwhile, Giuseppe Conte and the 5 Star Movement have thrown their weight behind a radical shift—a “shock therapy,” if you will. They propose redirecting funds from military spending towards healthcare, emphasizing that our real battle is against the deterioration of public health services, not on foreign battlefields.
The Disconnect Is Real
With figures expected to plummet, by 2027 we might see health expenditure dip below 6% of GDP—historically low and a clear signal that something’s got to give. As political figures voice their outrage, it’s clear that the public is being asked to bear the brunt of policy failures that prioritize profit over people and healthcare.
The government’s apparent negligence towards funding healthcare while watching industries like arms and pharmaceuticals thrive is drawing the ire of everyday citizens and lawmakers alike. The questions being raised aren’t just about numbers; they’re about the rights of millions and whether healthcare will remain a fundamental right or be relegated to the privy of those who can afford it.
So, as the nation grapples with these critical funding challenges, one thing is for sure: the battle over the future of the NHS is heating up, and it’s going to take more than wishful thinking to turn the tide. It’s time to put the health of citizens first and forge a path that emphasizes equality, accessibility, and compassion within our healthcare system.
