The Rising Costs and Impact of Healthcare on Family Budgets
In Lombardy, the region in northern Italy, the impact of healthcare on family budgets is becoming increasingly bitter. Long waiting lists for medical tests and visits are forcing individuals to open their wallets, resulting in significant financial strain. To truly understand the extent of this burden, it is necessary to consider three indicators: the number of paid diagnostic tests and medical visits, their cost, and the progress of requests.
According to Agenas, the National Agency for regional health services under the Ministry of Health, the people of Lombardy benefitted from a staggering 3,177,599 tests and 3,792,055 visits provided exclusively by public hospitals in 2022. These numbers almost double when including services provided by private clinics under the public health service.
The costs associated with these tests and visits are equally disheartening. The Cergas-Bocconi Observatory on Private Consumption in Healthcare estimates that out of every 100 diagnostic tests, 79 are covered by the National Health Service (SSN), while the remaining 21 must be paid for out-of-pocket. Similarly, out of every 100 medical visits, 59 are with the NHS and 41 require payment. Insurance reimbursement typically covers only a small portion, around 10%, of these costs. In Lombardy alone, over one million tests and nearly three million paid medical visits are projected for 2022, with one-third concentrated in Milan.
The variation in prices for the same exam is primarily attributed to two factors. Firstly, for tests such as CT scans, the price varies depending on the body region involved and the use of contrast methods. Secondly, the rate is determined by the individual doctor rather than the facility. Milan’s Sant’Agostino medical center, known for its affordable prices, has even raised its rates due to an inflationary flare-up. For instance, the cost of an ultrasound scan has increased from 65 euros to 77 euros. Furthermore, the demand for paid healthcare services has been consistently growing. Cergas-Bocconi reports a 10% increase from 2020 to 2021, and Agenas data reveals a further 15% increase in exams and a 2% increase in freelance visits for 2022. The surge in demand can be partially attributed to the impact of the pandemic, which disrupted public healthcare services and prompted individuals to seek alternative options.
Adding to the crisis is the shortage of doctors, leading to a constant organizational struggle within the public healthcare sector. In Lombardy, accredited private individuals play a crucial role, and in the absence of proper regulations, patients often opt for paid services or those that offer better reimbursements. In Milan specifically, the percentage of first visits carried out under the private regime increased from 41% in 2019 to 58% in 2022.
The overall organizational crisis and financial strain in the healthcare sector can be traced back to the choices made by national politics. Regardless of political color, governments have failed to prioritize healthcare. Experts gauge the government’s commitment to healthcare by examining the relationship between public funding for the NHS and GDP. Italy entered the pandemic with a financing level of 6.4% of GDP, significantly lower than Germany, France, and the United Kingdom. Although there was a surge in spending in 2020, reaching 7.3% of GDP, subsequent years saw a decline. Based on forecasts, funding is expected to decrease to 6.2% in 2025. As a result, citizens bear the brunt of these policies.
As healthcare costs continue to rise and waiting times grow longer, families in Lombardy and throughout Italy face increasingly challenging financial situations. The lack of investment and organizational crisis in the sector necessitate immediate attention and action from policymakers to alleviate the burden on families and provide accessible and affordable healthcare for all.