Princes and donkeys – Quotidiano Sanità

by Enzo Bozza

02 NOV – Dear Director,

what follows is a story that summarizes the whole drama of the Public Health Service: “Here, madam, in this letter I wrote everything, get your prescriptions made by your GP. They are 120 euros. Thank you and goodbye.” Mrs. Maria is happy, she managed to have her specialist visit in just two days at the ultra-specialized “Aiutatichediotiaiuta” clinic recommended by her trusted hairdresser. A slight bitterness: “how boring having to go to the general practitioner to have the prescriptions made, two hours of waiting for four sheets of paper, almost, almost a telephone …”.

From this story emerges all the ambiguity of the relationship between freelancers and the general practitioner who has become the NHS officer over the years, the one who compiles the prescriptions on behalf of the State, not even being an employee of it.

Eight times out of ten, he requests and signs exams designed and requested by other colleagues who work in the private sector and, for this reason, they cannot fill out the prescriptions on behalf of the NHS. With the schizophrenia typical of any public system, it takes two doctors to do one thing; one dictates and the other writes and signs. The cost of the thing doubles because a doctor pays the State and the other the citizen from his own pocket, who in reality would have already paid the service with taxes, but Mrs. Maria’s 120 euros are the protection money that must be paid to place things and to allow yourself the luxury of hurrying.

It is in this way that Healthcare is divided into two bands: the luxury one, of series A for those who can pay the 120 euros of Mrs. Maria and the public one with which you have to queue and wait for your turn from four to six. months later, it is that of series B. But is health not guaranteed for everyone? It depends: the law is the same for everyone but some are more equal than others.

This division does not only concern users, although it would be more correct to define them as customers, given the “commercial” system built around Health, the division also concerns Healthcare operators: Princes and donkeys: on the one hand those with an ultra-modern and efficient studio who dispense health privately after having given up the gown of the public hospital ward, and on the other the donkey of the semi-public medicine of the primary medicine clinics, poor and dilapidated clinics with the magazines of 10 years ago. The donkey is the one who copies tests and prescriptions and cannot prescribe drugs on his own initiative that need a treatment plan prescribed by medical specialists, because it is well known that the donkey knows neither diabetes nor asthma. For this he is paid a little per kilo, based on the kilos of paper he can produce.

And since he is the ass of the situation, he can only work less than the hospital principles, only three hours a day with a double salary because it is well known that in this country those who work less are always rewarded: it is the constant and chronic suicide of public affairs. , from Christian Democracy onwards. Can the pandemic challenge be met with this system? Obviously not. Science is the art of doubt but Medicine has come too close to cosmetics. Could it be also for this reason that the novax have distanced themselves? Thus, they all lived, or almost all, unhappy and discontented.

Enzo Bozza
General practitioner
Vodo di Cadore

November 02, 2021
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