Healthcare Inequality: The Unfortunate Reality of the National Health System
The National Health System (NHS) is facing a crisis, with the principle of equity in healthcare being increasingly compromised. According to the 21st Healthcare Report by Crea, the Center for Applied Economic Research in Healthcare, the percentage of private spending on healthcare has increased three times more among less well-off families compared to those with more economic possibilities. This disparity has significant implications for family budgets, with the impact of healthcare consumption more than doubling since the birth of the NHS, reaching an average of 4.3% and as high as 6.8% for the less educated.
The Burden on Low-Income Families
The data reveals that the highest price is paid by the least wealthy families, with the share of private spending supported by the 60% of the poorest families growing from 27.6% to 37.6%. This translates to a total private spending of 43.3 billion euros, almost a quarter of the total. The report highlights that 2.3 million residents experience economic hardship due to healthcare costs, with over 4 million families facing significant financial burdens, particularly in areas such as dentistry and long-term care for non-self-sufficient patients.
Geographical Disparities and the Need for Reform
The report also notes geographical differences, with the share of families spending on care initially higher in the North-East, but now higher in the Center and the South. The data suggests that private spending in the South is not only correlated to greater economic availability but also to shortcomings of the Public Service. The analysis emphasizes that the current structure of the NHS, without a paradigm shift, will not be able to respond to the evolving needs of the population, driven by demography and changes in social structures.
International Comparisons and the Way Forward
In international comparisons, Italian spending is around 10% lower, with the report concluding that an increase in spending would still leave Italy below the main European countries. The NHS was created to respond primarily to clinical needs related to acute cases, but it has been trying to adapt to the need to strengthen the management of chronic conditions. Crea believes that some revisions cannot be postponed, emphasizing the need to extend the globality of responses from the strictly clinical path to a ‘hybrid’ one, including social needs more generally.
For more information, read the full report Here