After the yes to the 2.3 billion cut in healthcare, now is the time for reorganization in hospitals and outpatient clinics. Reorganization means tightening up on analyses, visits and imaging tests. But also penalties for doctors who sign inappropriate prescriptions. Also salaries cut. By August the Ministry of Health should present the various protocols aimed at reducing waste: from the head to check the cholesterol level, to the CT scan, to the MRI, to the ultrasound in pregnancy up to hospitalizations. The operation concerns approximately 15% of the services that the health service currently provides free of charge. Two hundred, between analyzes and exams, are under the scrutiny and about 108 hospitalizations. In five years, at least 10 billion will have to be recovered. Savings on goods and services (for purchases from a single central office) will be added to those on personnel, hospitalizations and diagnostics. The services provided are 200 million a year, it is assumed that they will have to be 28 million less every twelve months. Useless analyzes and tests cost over 13 billion a year to the budget of the health system. A sort of black list has already been drawn up. In addition to the technicians of the Ministry of Health, eight other institutions are also at work, including Aifa (Italian Medicines Agency), the State General Accounting Office, the Bank of Italy and Consip.
THE TESTS
On the exams not an ax that cuts cleanly but yes or no to reimbursement according to the patient's health condition. As is the case with medicines. This means that for those affected by a particular pathology, a specific test is free, while for those without risk factors, payment is mandatory. To put a stop to the so-called "health consumerism" a mechanism could be introduced according to which in the event of multiple tests, the subsequent ones remain the responsibility of the health service only if the first indicates that they are necessary to arrive at drawing the diagnosis correctly. Or to verify the effect of a therapy.
If, for example, the analyzes to measure cholesterol or triglycerides should be repeated without specific alarms being highlighted, the assessment will be the responsibility of the citizen. One more example: it will not be possible to do an antibiogram (a test that allows you to evaluate whether a bacterium is sensitive to a given antibiotic) if the urine culture previously done has not shown values that are not within the norm. Genetic tests will only be reimbursed if a hereditary disease is diagnosed earlier.
PICTURES
Super review also for Tac, MRI and ultrasounds. Contingent and customized prescriptions. Only in cases of real need given the cost of these checks. The general practitioner will be given the new protocol, he will have to scrupulously comply with this, under penalty of reducing his salary. It is useless to insist with the basic doctor to have this or that exam. He will say no. Like today he says no if we ask for a drug not provided for our pathology. The doctor will be able to avoid sanctions in the event of inappropriate prescriptions by giving reasons for his decisions.
The Tac will be paid, for example, if you want to check for a hernia while the resonance will not be free if the patient has only simple back pain. And no knee MRI for those over 65.
PENDING
Possible tightening on arrival also for exams and ultrasounds during pregnancy. It was the Minister of Health himself who spoke of saving from waiting women. That's five hundred thousand a year. "There is an unjustifiable abundance of prescriptions," Beatrice Lorenzin ruled a few months ago. The investigations, therefore, will be contingent and modulated according to the conditions of the patient and the child. Those who want to undergo other tests will have to pay for them out of their own pocket.
THE HOSPITALITY
Increasingly shorter hospitalizations for various pathologies. Whether they are medical or surgical wards. Two or three more days in the ward means billions. The project is not new. It envisaged that the patients' exit from the hospital would be facilitated by the presence of assistance services in the neighborhood such as home care. But, only in a few Regions, has this continuity from the lane to home been achieved. Those treatments that until now required hospitalization will have to be converted into day hospital or outpatient treatment.
Related news: M5S press release HEALTHCARE BETWEEN DISMANTLING, WASTE AND LOBBY GIFTS
