Health spending paid out of pocket by Italians will see a surge of 10% in 2023 alone and, together with waiting lists, is the cause that leads 4.5 million people in Italy to give up treatment. These numbers, combined with regional inequalities, healthcare migration and crowded emergency rooms “demonstrate that the resilience of the national health service is close to the point of no return”. While for health spending there is a gap of 52 billion with the average of EU countries.
The Gimbe foundation denounces a “public health emergency”, but the health minister reassures “there will be adequate resources for healthcare in the budget law”. While it is up to the President of the Republic Sergio Mattarella to underline, once again, the value of the health service as a “precious resource and essential pillar for the protection of the right to health”.
Italians’ healthcare spending on private healthcare increased by 10.5% from 2022 to 2023 (Gimbe, Istat data processing)
On the eve of the G7 health meeting which is about to open in Ancona, the seventh Gimbe report on the national health service shows that compared to 2022, in 2023 the increase in total health spending was supported exclusively by families as direct expenditure or through funds and insurance . While Italian public health spending remains stable, compared to the average of the OECD member countries of the European Union, there is a gap of almost 52.4 billion accumulated in the last 11 years and “puts us at the rear, with a difference that is now unbridgeable with other countries”. The consequence is that more and more people, he explains Nino Cartabellottapresident of Gimbe, “are forced to pay for an increasing number of healthcare services out of their own pockets”: it is called ‘out-of-pocket’ spending and, if in the period 2021-2022 it recorded an average annual increase of 1.6 %, in 2023 it surged, increasing by 10.3% in just one year. And this is one of the main reasons that in 2023 led 4 and a half million people to give up medical visits or tests for various reasons. “The serious sustainability crisis of the national health service is the result of the defunding implemented over the last 15 years by all governments”, observes Cartabellotta.
In 2023, 4.5 million Italians have given up on healthcare spending. This is the percentage data for the Regions (Istat 2023)
“The forecasts do not suggest any revival of public financing for healthcare”: according to the structural budget plan (PSB), the healthcare expenditure/GDP ratio will reduce from 6.3% in 2024-2025 to 6.2% in 2026 -2027. And, compared to an average annual growth in nominal GDP of 2.8%, in the three-year period 2025-2027 the PSB estimates an average growth in health spending of 2.3%. “These data – explains Cartabellotta – confirm that the defunding continues”. And they go hand in hand with an “unprecedented staff crisis”, squeezed between exhausting shifts, burnout and low pay. While the implementation of the Pnrr health mission projects “is already affected by the inequalities between the north and south of the country”. Given this, Gimbe calls for a majority-opposition pact.
The gap in public health spending per capita between Italy and the OECD average is $995 per capita, almost 54 billion euros (Gimbe elaboration on OECD data)
They were the two main opposition leaders, Elly Schlein and Giuseppe Conte to attend, both in the presence but far from each other, the presentation of the report. “We ask for more resources for public health”, said the secretary of the Democratic Party, who relaunches the proposal: “the spending that families put out of their own pockets has increased by 4.3 billion, i.e. the same amount that the government put into the reform of the personal income tax. So we will ask, also in this maneuver, to put those 4.3 billion on public health because, if this doesn’t happen, it will fall on families”.
The Minister of Health Orazio Schillaci he replies: “no one in the Government wants to cut public healthcare, something that the opposition constantly reminds us of”. He then specifies that the main objectives of the next budget law are “to pay staff better” and “to have a multi-year plan to hire new doctors”.
National healthcare requirement trend 2010/2024 (Gimbe)