Health is a priority for Italians: 69% of citizens put investments in health first, ahead of work and energy costs; a growing figure compared to the last two years, also as a result of Covid and the constant increase in life expectancy. Emergency room, hospital care and prevention are the three priority areas in which to intervene with greater urgency. The opinion poll shows it “Italians’ priorities and expectations for a new NHS” presented today in Rome on the occasion of the sixth edition of “Inventing for Life Health Summit” organized by MSD Italia and dedicated to the theme “Investing for Life: Health matters!” on the topics of innovation and research, the public-private relationship, the most urgent critical issues and the transformations of the country’s healthcare system.
The demographic forecast linked to the aging of the population and social and epidemiological emergencies were among the main concerns that emerged during the day’s work, in addition to the lack of integration between health services and social services, regional differences and the need for greater efficiency and financing for healthcare.
Defend the universalistic system
The Ipsos survey monitors the relationship and perception of healthcare by the Italian population which promotes the national healthcare system, positively evaluated by six out of 10 Italians, but for nine out of 10 Italians it must be financed more; 38% believe that public spending on healthcare is lower than that of other countries and, in fact, we invest half as much in health compared to GDP as Germany does. «Countries like the USA invest 20% of their GDP in health, with lower health outcomes. Our universalistic system is more efficient” he commented Amerigo Cicchetti, general director of health planning at the Ministry of Health.
With chronicity, the demand increases
From 2019 to today, healthcare spending has gone from 114 to 134 billion euros. It is not enough. An invitation not to limit ourselves to absolute figures but to look at the reality of needs came from president of the Italian medical oncology association Aiom, Francesco Perrone: «We are witnessing an increase in incidence but also in prevalence, precisely due to the aging of the population and the increased capacity of treatments that lead to chronicity. This results in a greater number of patients which, therefore, leads to an increase in demand for resources and professionals.” As for oncology, «it is true that we are the highest item of expenditure, but here principles such as appropriateness and multidisciplinary organization have already prevailed for some time. Today the most significant problems of the system are represented by unfair inequalities of various types: waiting times, access to care, access to screening. Finally, better communication is needed between scientific societies and institutions and I think of the new Aifa with a bit of anxiety.”
Health and healthcare are government priorities
For one in three respondents, the role of the state should increase, 42% call for a greater role of the Regions. «In the expectations of Italian public opinion, health and healthcare remain the first priority for the Government» observed Nando Pagnoncelli, president of Ipsos. «The rationalizations affecting public health, amplified by news reports on the pressure to which health workers are subjected, reinforce the urgency of expected action on hospital services and care, especially first aid».
Prevention in the spotlight
«Prevention can be the true actor of change and a driver for the sustainability of the healthcare system. Inverting the paradigm is extremely important: 60% of chronic and chronic-degenerative diseases and 40% of oncological diseases can be prevented by lifestyle” he said Francesco Vaia, general director of health prevention at the Ministrywhich invites you to immediately adopt a vision life course, paying attention to your choices with a view to future health. As? «As individuals, adopting a health calendar, which includes vaccination stages, screenings and lifestyles; and as a country system being a little closer to the citizens. Communication is key. People want to understand”
The role of patients and associations
More than eight out of 10 Italians are convinced that patients should be actively involved in treatment decision-making processes e only half of the respondents claim that the right attention is given to their specific needs in the diagnostic-assistance process. «67% of Italians believe that patient associations are generally present in favor of patients, but some critical elements emerge: 53% of them believe they could do more, only 14% believe they are present and 32% believe they are completely absent and leave the patient to themselves. Expectations are evidently changing.” observed Nando Pagnoncelli. Also commenting on the data Annalisa Scopinaro, president of Uniamo: «Associations are often expected to provide services that the state does not provide. Instead, providing services is not technically our objective, but we work at a broader level to defend the interests of patients and their involvement at every table in every phase, from the definition of needs to the evaluation of performance.” According to the survey, the associations still play a discreet informative role, in a context in which 65% of the Italians interviewed declare they have come across fake news. The main source of information on health issues is the family doctor (28%), followed by TV (26%) and the Internet (17%). The family doctor once again represents the most reliable source (50%), followed by patient associations which are acquiring ever greater importance (from 24% to 28%) and the Internet which, over the years, is progressively losing its authority (-8 percentage points vs 2021).
The care relationship
The share of Italians who believe digital transformation and artificial intelligence in the healthcare field is decreasing (from 79% to 68%). While on the one hand they believe that they are useful for activities such as the automation of tasks, the analysis of data to support prevention and more accurate diagnoses, on the other they do not consider them as such due to the fear of a possible lack of contact human: «A special mention deserves the opinions we have collected on the digitalisation of healthcare, a central element of Mission 6 of the Pnrr: the rapidity of the evolution of digital tools, think of generative AI, is generating conflicting feelings in public opinion, with anxieties and expectations” commented Pagnoncelli. «The fear of the loss of indispensable human contact is compensated by the expectation of efficiency in processes and progress in the precision and speed of diagnoses. The recognition of the role of the pharmaceutical industry remains high and stable and the belief that it is a potential stimulus to the country’s economic growth is also robust.”
Investing in health
«We live in a difficult context. The recent Stability Pact provides for an increase in public investments in sectors such as climate and digital transition, energy security and defence, some of the major critical issues we face in an increasingly problematic global context” said Nicoletta Luppi, president and CEO of MSD Italia. «And yet, for all of us who daily commit ourselves with passion and dedication to this sector, and the pandemic should have taught everyone this, the risks seem clear and numerous: from antimicrobial resistance to vaccination hesitancy, from infectious diseases to discomfort mental, from the impoverishment of the quality of life in the face of an aging population, to burnout and shortages of healthcare personnel”. Finally, «this is the time to rethink priorities regarding spending and public budgets. Investing in health, we know, by definition produces a positive impact on citizens and patients and plays a decisive and strategic role in the economic growth of the country, just think that the pharmaceutical sector contributes 2% to the Italian GDP and, furthermore, produces a holistic positive impact, with many positive implications on the Sustainable Development Goals.”
Public and private, new synergies
Also speaking at the Roman summit was health minister Orazio Schillaci, who listed some urgencies and defined the strategies: «I am thinking of the issue of waiting lists and unacceptable waiting issues, for which we have allocated funds and created a working group, we also need real data and to understand which performances and which regions present the greatest critical issues. Then there is the issue of emergency room visits, avoidable in 40% of cases, due to the lack of local medicine. Citizens in the PS receive an answer to health issues first, but it is necessary to promote more appropriate use. We are encouraging collaboration between public and private, it is time to look at synergies with favor and not with suspicion. We cannot think of modernizing healthcare while remaining tied to old cultural models. It should be kept in mind that healthcare is not just a cost but an investment. Innovations have a cost but they allow savings in assistance and care.” Last but not least, «prevention, which for years has disappeared from the debate, considered the Cinderella of the system because it does not give immediate results, is fundamental for the state of health and the economic sustainability of the healthcare system. We must take care of the healthy, encourage lifestyles and participation in screening.”
Yes to vaccinations
Almost eight out of 10 Italians are convinced that vaccines save lives and maintain that they are important to protect even those who cannot get vaccinated. A clear majority of Italians are in favor of greater involvement of pharmacies in vaccinations (78%) because they are considered more accessible than hospitals or medical centers and to allow a reduction in the workload on hospitals. “The poor adherence to the HPV vaccination, offered free of charge to adolescents and able to protect against forms of cancer, is surprising and worrying” he commented Carlo Signorelli, president of the National Technical Group on Nitag vaccinations.
Efficiency is good, but investments are needed
«Associations care about the health of others, those who have been through it want to spare others the experience of illness that overwhelms the person and the family. We are also uncomfortable, due to our frankness. However, in addition to greater spending efficiency, new investments are needed” he concluded Elisabetta Iannelli, general secretary of Favo. «It is of fundamental importance for patient associations to invest and optimize resources for cancer screening and treatment as required by the Mission on Cancer and Europe’s Beating Cancer Plan which aim to save millions of human lives: Prevent what is preventable. We are far from the objective set by the EU of guaranteeing that 90% of the population has access to oncological screening and papillomavirus vaccination. Reducing the burden of preventable and early-diagnosable diseases is a fruitful investment for the Healthcare and Welfare State and also means reducing the burden of pain and the financial toxicity that cancer and anti-tumor treatments entail for the patient and his family. To return to the title of today’s summit, I would conclude with Is health expensive? Health matters!».
Photo: Proforma press office