03/09/2021
of Cassa Forense
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More than 30,000 services were provided for approximately 30,000.00 million euros
In the historical moment we are experiencing, characterized by a serious pandemic, in which practically the entire world population is struggling to defeat the Covid-19 virus and to get out of the global crisis caused by its spread, it is natural to reflect on the importance of protecting our health.
It may seem trivial to underline it, but the events they have shown us that the ability to prevent and cure health pathologies of a country, whether caused by disease and / or seniority, directly and heavily affects the well-being of citizens and the economic-working system.
In the now distant 2001 Cassa Forense, in implementation of the provisions of Regulations for the provision of assistance, has stipulated the first collective health policy in favor of members for major surgeries and serious morbid events.
Over the years, the insurance has been expanded in terms of guarantees, providing for coverage, by way of example, the oncological guarantee, some highly specialized services and the check-up, as well as the possibility of benefiting, alternatively to direct payment or reimbursement of expenses , of the indemnity in lieu of hospitalization and beneficiaries: in addition to the so-called policy base, today it is possible to extend the coverage to the family members of the member and voluntarily join the supplementary health plans called A and B.
The health policy is free and automatic as for the basic coverage in favor of the members, voluntary and subject to the payment of a premium in the agreement for the extension to family members and supplementary coverage.
The data in the table below (Tab. 1. Data as at 30 April 2021) show the use by lawyers of the health insurance guarantee in the last two years. The numbers are likely to settle in light of the claims filing requests that will arrive in the coming months. In fact, the insurance coverage concerns the events and health services that took place during the year considered, which the insured person can transmit for settlement within two years from the event / service.
As we can see from the first table, the number of claims (requests for healthcare services) for the insurance year 2020-2021, is equal to n. 26,507, with a total cost of € 29,500.989 slightly lower than the previous year.
Analyzing the disaggregated data, we see that there is numerical homogeneity between requests and costs of the 2020-2021 annuality compared to the 2019-2020 annuality for highly specialized healthcare services, requests for convalescence allowance, dental services, preventive assessments and intensive care admissions for Covid-19 (data in blue).
Otherwise, for the year 2020-2021 the benefits for serious morbid events, the indemnities in lieu of hospitalization, the benefits for oncological diseases, hospitalizations for major surgery and those for Covid-19, treatments for metabolic syndrome as well as , in general, medical and health examinations and examinations (data in green). In keeping with the national trend of health services at the national level, the requests for compensation for isolation and hospitalization from Covid-19 not in intensive care have increased (data in yellow).
The usage data of the supplementary health plans A + B by the members of Cassa Forense, referred to in the following table, shows us that in 2020-2021, compared to the previous year, requests for replacement allowances for hospitalization and outpatient health services, physiotherapy treatments for post traumatic rehabilitation , visits and medical-health checks (data in yellow).
Highly diagnostic specialist services decreased (data in green), while dental services and hospitalizations were substantially unchanged (data in blue).
Comparison between the use of the basic policy and the supplementary ones – Public services
The disaggregated data relating to the comparison in the use of the Cassa Forense health policy between members, family members, pensioners, lawyers no longer registered with the Cassa and survivors, as per the following table (tab. 3).
In the face of a total number of requests for health care services decreasing in 2020-2021 compared to 2019-2020, the decrease is more pronounced for the basic health plan than for the supplementary ones. For the basic health plan, we see the growth in benefits for the benefit of retired lawyers no longer registered with the Fund and survivors compared to the requests of members and family members.
For the supplementary health plans A + B, requests from family members decrease in 2020-2021 but those of members and pensioners no longer registered with the Fund and survivors increase.
The growth in the number of medical examinations and medical examinations of the supplementary plans A + B it can be a positive indication of a gradual resumption of non-urgent health care and preventive medicine by Italian lawyers and their families.
In general, for the Italian population, the health emergency that we have experienced and are still experiencing raises fears of consequences that are not easily foreseeable today in terms of aggravation of diseases that have not been treated or diagnosed during the pandemic. In fact, we know that the pandemic, in Italy but also in many foreign countries, has had a dramatic effect on mortality not only due to the deaths it directly caused but also because it has aggravated the fragile conditions of the population, especially the elderly and already affected ones. from pathologies.
The numbers on local health care activities, relating to specialist visits and diagnostic tests, indicate a general decrease in services, including those that cannot be postponed. The phenomenon can be explained on the one hand by the reduced availability of health resources for diseases other than Covid-19 and on the other by the tendency of the population to postpone medical treatment for fear of exposing themselves to contagion. It is expected that delays and renunciations of health services aimed at treating diseases in an acute phase or for prevention activities will have consequences on the health of the population.
The available data document, in the first two months of the health crisis, an increase in deaths linked to diseases for which timeliness and regularity of treatment are often decisive. As an extreme consequence of this phenomenon, the excess mortality due to the pandemic has significantly reduced the life expectancy of the population in a non-homogeneous way on the Italian territory, penalizing more the areas of the North.
It is interesting to note that in 2020, in the face of the 1.2 year decrease in life expectancy at birth, the indicator of good health perceived by the Italian population has instead improved: the share of Istat respondents who declare that they are well or very well grew by about 3 percentage points compared to 2019.
The increase affects all categories without particular gender, generation or territorial area of reference, and is particularly accentuated among women aged 35-54, for whom it doubles. This phenomenon has been partly explained for psychological and emotional reasons: the drama of the events has led to no longer taking one’s situation for granted and to emphasize its appreciation. In part, however, and the data raises concerns, the data was linked to the decrease in medical care by citizens who benefited from fewer diagnostic visits, too; this could lead to a lack of awareness of being affected by chronic diseases. Lastly, the lockdown phases and restrictions on circulation and interpersonal contacts have certainly reduced people’s exposure to external risks with a decrease in the incidence of acute diseases. Nationally, in 2020 the outpatient and specialist services provided decreased by 20.3 percent compared to the previous year. The following table shows large differences between territories which lead to an accentuation of the already existing inequalities.
The lower access to benefits affected men and women equally, while there are differences by age group: pediatric is the most involved, with a decline of 33 percent, followed by adults between 35 and 54 years (-22 percent).
For other ages, the reduction is between 18 and 22 percent. The intensity of the phenomenon also varies according to the type of service and those of less urgency and severity are more penalized. In particular, the biggest drops concerned the rehabilitation and visits components.
In conclusion, the numbers on the use of the Cassa Forense health policy by members, family members, pensioners no longer registered with the Cassa and survivors confirm the great usefulness of this welfare tool for lawyers and lead us to evaluate its importance not only from the point of view of health care with respect to the pathologies already known and which have arisen but also in terms of disease prevention.