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Often they refer to the huge
mass of expenditures the Italian National Health Service deals, but
they forget at all a hidden chapter whose magnitude is practically impossible
to establish a priori. Let's quote a banal example: maintenance expenditure
of residential or commercial real estates which, due to a legacy maybe,
are property of some Health Body, or the expenditure for the leasehold
of a unproductive country estate, fall in the item expenditure of this
Body balance, even if they do not concern Health at all. The expenditures
in order to warrant an insurance coverage having nothing to do with
health assistance but referring to the real estates of a Health Body.
We will find them all the same at the item expenditures of the Health
Balance.
What falls in health, but must not at all burden the balance is the huge
mass of expenditures related to traumatology and consequences, since
there's an exact patient's responsibility or third-party 's responsibility
in provoking the pathology making applying for health assistance. The
number of surgery interventions in Health for events for which there's
a third-party liability is huge and the expenditure is boundless. In
front of these Health Service interventions nobody deals with a timely
and exact enquiry about the responsible to whom charge each item of
expenditure that has nothing to do with health assistance whereas it
concerns lesions provoked by an accident and there's a precise responsible,
often well individuated. On the other side, almost always there's an
insurance coverage of the responsible, who under the item third-party
liability, has insured himself against eventual and not foreseen risks
of expenditures. National Health System and Insurances Companies Association
seem to havie got to a flat value for the reimbursements of expenditures
for lesions provoked to third-party by their ensured and it seems they
pay national level a quota “una tantum” to the Health Service.
Which basis will lie this quota if it is not established exactly how
much the service has real spent for each patient? Very often the damaged
is indemnified, but who is the real damaged: the patient or who has
spent ten of millions to cure him?
In order to evaluate the single figures to charge to the responsible
of the damage it would be necessary to highlight them time by time,
to set them apart from health expenditures and transfer them to a special
item managed independently from others by the Legal Department able
to carry out the inquiry about the responsible and the recover of the
whole expenditure, even the legal ones for each event, without making
them charging over the collectivity balance surely not responsible of
the event.It's very comfortable getting out with a n indefinite speech
about the solidarity of the Health Service, free at all for everybody
and assisting everybody from the cradle to the coffin.
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Mensile di scienza medica e
attualita`