by Enzo Bozza
20 JUN – Dear Director,
the Bignami of the market economy explains that “if you increase the supply, you will also increase the demand for a product. Then, it is also up to advertising to make that product seem indispensable for everyone’s well-being”. Usually, it’s a useless product, but how can you live without it if everyone is talking about it? Even here in Cadore, among the splendid Belluno mountains, the same strategy applies. In fact, I read the advertising flyer of a private laboratory that offers various exam packages with suggestive headings: Salute Donna, 33 exams for a total cost of 85 euros, Salute Uomo, with 35 exams for 90 euros, again the usual gender discrimination , human health costs more. On the title page of the leaflet, the inscription: a medical prescription is not required.
This is the crux of the whole matter: the doctor has nothing to do with it, it’s just a commercial relationship between supply and demand for a product as trivialized as blood tests that you can buy them in packets like at the supermarket. You do not have time? Don’t want to queue? But did some friend tell you that you should do something about your health? Don’t worry, we’re here. Only 90 euros.
I have always appreciated entrepreneurship and free initiative, but we know very well that the market needs a bit of shrewdness and a pinch of piracy to slip a little money out of your wallet in exchange for the usual Trevi fountain for sale to the ingenuous on duty, as Totò teaches. But in the case of the private analysis laboratory, the question is dangerous and illuminating. Dangerous because it starts from the principle that good health and prevention are based on a package of tests that is independent of any upstream clinical evaluation by a doctor. Too many have forgotten that the clinic is made by the doctor who requires tests related to the patient’s situation and circumstances. The subversion of this logic includes another anomaly: when the patient will have this packet of tests in hand, who will read them and who will make a diagnosis, the patient himself? Considering that the doctor has already been excluded a priori.
The danger lies in the belief that the concept of good health is all here, spending only 90 euros and without bothering anyone. Reservations, expectations, appointments with the general practitioner, comparison with his point of view. All useless stuff, there’s a shortcut and this is the short circuit of general practitioner assistance and work.
The story is enlightening because it says that we are moving in the field of health marketing, of the vision of the NHS in a supermarket key where you can buy what you need, making you believe that it is indispensable and instead you are buying the usual useless stuff that you can present as good prevention practice. They make you buy the car without having a license to drive it. Who allows all this, who authorizes a vulgar, false and immoral market? Simply, politics, which evaluates healthcare only and always in terms of costs and the market, without ever considering the only fundamental element: people’s health.
By the way, this public health thing has always been a big pain in the ass. Why put a state budget when people can reach for their wallets and get what they want, skipping waiting lists and public disservices? In fact, one of the reasons why every government has left the NHS in disarray is that no minister has ever gone to a general practitioner or emergency room. At the slightest illness, “the honorable” always has a private clinic or a luminary on duty at hand. Have you ever seen him queue with a number in his hand?
The extraordinary political ability not to descend among the people and understand the problems is an all-Italian constant, on the right as on the left. But if the minister is on the run, neither is the market which knows very well what the people want, even here in Cadore where the health discount stores are opening up.
In these parts, it is said that when the water reaches the gorge, you learn to swim. In fact, the brand new Minister of Health has understood very well where the water has arrived, lately, and seems to want to reform the NHS, starting from the bottom up, from local medicine. Survival: He realized he was the head of a dying ministry. Too bad that the same foresight is not seen on the part of Fimmg and Enpam, who continue to dance on the deck, while the Titanic sinks.
Enzo Bozza
General practitioner in Vodo and Borca di Cadore (BL)
June 20, 2023
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