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Commentary. A new report in Italy shows that 11 million people skipped health treatments so far this year for lack of money.

Better health care, but only for those who pay

The program is in full effect. They thought of eliminating public health, and they are successfully doing it. But with a careful and programmed senescence of structures and an entrenchment of insecurity, a multiplication of the waiting lists, incompatible with the schedules for check-ups and illnesses, leaving, as sole solution, the appeal to health and to private insurance.

Goodbye, public welfare. The crisis is here, and you’re without an income? You don’t take care of yourself, you don’t check yourself up? You die. It’s life, they say. But this is not life, according to a welfare’s canons. And it shouldn’t be.

Eleven million people had to give up medical treatment in 2016. According to the research carried out by Censis-Rbm Assicurazione Salute, shown Wednesday in Rome during “Welfare Day,” this is the outcome of the law instituted by social darwinism: more treatments, but only for those who can afford them.

The trend is clear: Since 2012, 2 million more people were blocked by the apparatus governing life during austerity. They are elderly, and those 2.4 million people can be understood. But the effects of poverty can be felt also on 2.2 million “millennials.” This expression, taken from the arsenal of fetish words, is intended to mean the young people, under the form of a merchandise category. From the United States to France, for example, the “millennials” are defined as “Generation Y” but also as “Next Generation” or “Net Generation.” There is also talk about “Echo boomers” to differentiate them from the “Baby boomers,” the people born after World War II, the generation that saw the birth of the national health system, instituted in Italy by Law in 1978. Generally, the law of “those who pay are (better) treated” applies also to those born between the end of the ‘80s and Sept. 11. This is the shocking data, for which a culture that knows how to explain the why, still doesn’t exist: These young people will not be able to treat themselves.

They won’t be able to do it because, research says, they don’t have the income to pay for the increased bills: 45.4 percent (5.6 percent more than 2013) paid private fees equal or not much higher than the public ones. The number of Italians who, in the last year, have appealed to intra moenia is 7.1 million: 66.4 percent in order to avoid long waiting lines. And it’s understandable: If you have to do an ultrasound to find out if you have a tumor, you would want to know immediately. Not in a year. About 30 percent of the sample sustains they turned toward paid health care. What will people do if they can’t afford to find out about the tumor? Get a loan? Probably.

In relation to the waiting lists, the report formulates some sort of theory: The longer they are, the less preferred is paid health care. Not only that, they even formulate the connected theory: The more Italians who sign a health policy or join an integrative health fund, the more public health will free up resources equal to €15 billion in order to cover services for underprivileged citizens.

A report’s main thesis: that private health insurance markets, like private health care, must be fed. And evaluations or perspectives of this kind do that. Provided these numbers are true, there is a problem: A state that cuts health expenses, like Italy did in 2009, considers the €15 billion discussed as being “savings.” And it will cut them. It’s the vicious circle of austerity in which even local government entities have fallen. Without taking into account the fact that the “lucky ones” who have enough income to allow them to turn to private health care — let’s say the middle class — are also afflicted by the crisis.

Neoliberalism bets on the families’ incomes. It’s useful to sustain the insecurity of children and the health of parents and grandparents. An evidently daring bet: financial logic and its legendary ability to produce money from money. This would be valid also for families with their savings in the bank. But the incomes say something totally different.

The Renzi government is thinking about supporting the middle class and the employed class with the €80 income tax bonus. The report shows that the €80 will be used to pay for private health: From 2013 to 2015 the sum has increased from €485 to €569 per person, and the private expense is equal to €34.5 billion, an increase of 3.2 percent: double the increase of the expense for family consumption.

Here is shown, in a few words, the fallacy of Renzi’s theorem. “It’s clear that the National Health System must deal with the major economic crisis the families are going through. It must be clear that weddings are not carried out with dry figs,” said cruelly Health Minister Lorenzin, who defends the micro increase of the national health fund and the micro-unblocking of personnel turn-over.

Unfortunately the crisis has also been produced by cuts to health which have not been re-financed by the government. “The cuts induce people to not get treatment,” Susanna Camusso (Italian General Confederation of Labor) claims. For Constantino Troise (Anaao) also, skipping treatments is a consequence of this government’s choices.

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