Year XVII n.04-01

 

 

 

 

 

Amedeo Pavone

The reappearance of foot-and-mouth disease in endemic form in the UK - which could easily turn epidemic and quickly become pandemic at European level - has brought to the attention of a shocked public opinion, in a preponderant manner, the very serious problem of a number of diseases that seemed to have disappeared and which had been forgotten and of just how easily certain infections can spread. Smallpox and polio no longer exist in Italy and right back in 1981, there was talk of abolishing these vaccinations in the year 2000, because they were no longer considered necessary.Today however, people no longer travel by sea and even pollen moves about from one continent to another in the air-conditioning filters of jet planes, managing to cause new allergies in areas surrounding modern airports such as Malpensa, due to the strange flowers born from spores that jet exhausts disperse over the land. And then of course, we must also add the bacteria and viruses carried by travellers on those planes. Not to speak of the peaceful invasion of entire populations from areas where conflicts and illnesses have cancelled out whole villages. By ignoring the enormous risk of contagion, we have left ourselves open to attack from such diseases as tuberculosis and malaria, which have reappeared in various parts of Italy after a long absence. Illnesses thought to belong to the history of medicine are coming back with a vengeance, often with mutations and more resistant - very different to those of times past. Microbes and viruses are also living their age of globalisation. Thus certainties are questioned that had shifted attention onto metabolic, cardiovascular and neoplastic ailments, in the conviction that certain infectious diseases, however serious, were restricted to the so-called Third World, from which we are separated by thousand of kilometres, but also by centuries of history and culture. The current health system has cancelled out Anti-TB consortiums, Infectious Disease Departments and whole Hygiene and Preventive Treatment organisations. Everything has been put in the hands of the ASL (Local Health Units), which have to deal with problems that go from new-born babies to terminal patients, from town-planning to the prevention of accidents at work, from the safety of lifts to animal husbandry and food control. The result is that everything is done badly....when it is done at all! It is pretty obvious that certain problems require ultra-specialist organisations that cannot be improvised. Today, people no longer live in small rural villages where health problems could be easily restricted, but rather in big towns and cities where requirements are enormous and call for highly-qualified personnel and organisations. The fact nonetheless remains that the globalisation of illnesses requires the globalisation of procedures involving far-off populations, which must be helped to defend themselves in their countries of origin, overcoming nationalistic limitations and trying to combine efforts both in the field of scientific research and in the field of Health. It is a problem of civility. (traduzione Interpres sas-Giussano)






A recent decision issued by the Regional Appellate Tax Commission of Rome, section no. 14, against which the Tax Offices have not appealed to the State Commission thereby making it immediately executive, has decreed, in no uncertain terms: “The ENPAM (National Organisation for Illness Assistance Security) benefit must be taxed at the fixed tax rate of 12.5% on the part constituting the difference between the sum paid out and the total amount of the premiums paid in. It must prepare to reimburse the amounts withheld in excess of this amount compared with the tax system described above.” In issue no. 9/2000 of Leadership Medica, we have made an in depth report on the absurd reasoning of a Revenue office, which expects to tax the ENPAM benefits and pension payments at the same rate as a normal working income. However, it is quite clear that, since these involve contributions made to a private foundation to be accrued into personal accounts, there are obvious analogies with the deposits made to an insurance company for a normal life insurance policy. The Regional Commission was drastic, recognising the applicability in the tax legislation of the principle of equalisation of the ENPAM payments to the capital paid out as a consequence to life insurance policies since it “constitutes non-speculative remuneration of amounts accrued gradually over the years”. As we can easily see, the decision, while referring to a capital liquidation, also makes express reference to pensions that are equivalent to a lifetime annuity. The Tax Offices went no further and accepted restitution of the amount of the partial payment in excess of 12.50% already withheld by ENPAM at the time of the first liquidation without appealing to the higher State Commission, evidently because they were attempting to confine the application of the regulation exclusively to the case examined by the Regional Tax Commission. A possible definitive decision by the Supreme Jurisdictional Body would have had a value “erga omnes” and therefore it would have been impossible to limit its applicability. Of course, as far as the Italian Revenue Service is concerned, we are all tax evaders, so even the retired doctor must be struck down and the investigation of a payment statement of the pension of a doctor immediately shows the discrepancy existing between the amount paid by ENPAM under the form of a pension which the doctor is owed in view of the deposits made monthly throughout his working life and the amount that he can really collect at the end of the month. It is clear that, even in considering the stinginess of the Revenue service, we have to find some other way - political, judicial, or labour - to be able to confront the Italian government with its responsibilities towards someone who throughout his entire career worked for accessible fees in order to meet halfway the concepts of solidarity that the Government unloads onto doctors, to find himself mocked by the Revenue service which reserves a privileged treatment to those who, having the possibility, have handed their capital over to an Insurance Company. (traduzione Interpres sas-Giussano)