REUTERS HEALTH, 26 November 2001.

Italy Outlines Health Spending Cutbacks

FLORENCE (Reuters Health) - The Italian government on Thursday detailed cuts in the national healthcare budget designed to save 1.4 trillion lira in the first year.

The cutbacks were hammered out in an agreement between the national government and the regions. The State-Region Conference approved a shortened list of treatments that will be guaranteed all over the country, either free of charge or with a contribution by individuals.

The healthcare spending bill also specifies the therapies and treatments that the national health system will no longer provide, and for which patients will have to pay entirely.

The ``black list'' includes alternative therapies, plastic surgery except for cases of accidents or congenital malformations, dental treatment except for children and ''particularly vulnerable categories,'' circumcision, refractive surgery except for particularly serious cases and vaccines for travelling purposes.

Avoiding waste is also key in hospital treatments. The document on the basic levels of health assistance contains a list of 43 types of ``inappropriate'' admissions.

For these treatments patients will have to undergo day surgery or ambulatory treatment. They include arthroscopy, cataract surgery, skin traumas, vein stripping and urinary calculosis without complications.

The cuts are supposed to guarantee savings of 1.4 trillion lira in the first year.

Since the new health spending law limits pharmaceutical spending to 13% of the overall health budget, each region will be allowed to ask patients for a contribution to help pay for drugs.

The document divides drugs in four categories. Drugs in the first category will be totally reimbursed throughout the country. The remaining three categories include drugs for which contributions of 20%, 50% or 100% can be requested.

``This agreement has been made without significant cuts for the citizens,'' Health Minister Girolamo Sirchia said in an official statement. ``This long and meticulous work to indicate the basic levels of assistance will produce great advantages in clinics and healthcare organizations.''

The basic levels of health assistance will have to be approved by the Council of Ministers but are expected to take effect by November 30.

(File revised 12 March 2004)