............................
Amedeo Pavone
In the
earlier meeting of the SNAMI hold at Gardone Riviera, it was highlighted the
several bent ideas contained in the legislative decree passed by the Counsel
of Minister when reviewing the Law instituting the National health service
that in fact will turn into a state service.
The latter disposal, Snami's president Anzalone said, creates a real state
of confusion for all the Italian physicians and highlights the resolute collectivist
trend of the minister of health: - Rigid rules and binding protocols - Law
made under delegate power - Contractual changes introduced by the financial
act - Pretence to decide unilaterally the practice of a profession - Lowering
of the age limits for retirement imposed without taking into account the effective
impact of the actuarial computation.
Anzalone has also denounced the guilty delays of the Medical organization
against this behaviour marching on since more than a year.
The Law made under delegate power passed last year have indeed gave the minister,
by an insidious, understated, expressed in political jargon language, the
possibility to build a very wide law not requiring discussion and approval
by the parliament . It's just against the lack of precision of the delegation
that the Lombardy region has promoted an brought an action about the constitutional
legitimacy of a rule that cannot refer to general matters or general sectors,
but rather must refer to defined and exact objects: “reading the disposals
contained in art.2 it evicts clearly as the sizeable part of them, instead
of dictate directive principles and criteria, sometimes individuate, sometimes
state precisely the object of the delegation, an object that is not limited
at all but rather is very wide, for the lack of principles cannot deemed as
justified neither in the light of what stated by the constitutional jurisprudence
“.
To this appeal regarding constitutional legitimacy, raised by the Lombardy
Region, the Snami decided to adhere by appearing before the court of the trade
union. On the altar of the nationalization it has been sacrificed the entire
medical category, regardless of everyone.
This point, it does not remains but informing citizens about the fact that
the most penalised by this state behaviours will be the patients who must
undergo all the consequences of a system that by the means of continuous imposing
of extorted charges, binding State protocols, rules issued by law, continuous
and oppressive bureaucratic straining, will carry only damages to whom must
apply for the system.
Medicine has not a purpose in itself, its aim is to help patients, it's logic,
and so citizens must be associated to safeguard them against the risks of
disease, ensuring them a personal human medicine, a quality medicine, so a
free medicine because it's only this way it is replied the best to patient's
requirements and it is achieved the inexpensiveness of service. We must struggle
for a medicine that is the defence both of the collectivity and persons.
The single man, the person wants to live healthy and the ill man wants to
recover. It does not matter if medicine is a question of society and struggling
for a better and on human scale medicine, we contribute to a better society.
When man wants to safeguard his health condition he is alone in his experiences,
then he wants to be considered as a single entity, he cares of his health,
he cares of his freedom.
The only problem regards making everybody understand which is the real interest
of the single citizen. If we succeeded to this realization, we will be satisfied
to have concurred together to safeguard the single citizen's freedom, healthy
and ill, the freedom of Physician, and by doing that, the freedom in our country
“. With these exalting words the President of the Snami Anzalone ended
his speech at the Meeting of Gardone and started off the mobilisation of physicians
and citizens to safeguard their own rights.
Getting closer little by little
to the neck of the state's great funnel where our rulers has thrown all the
Italian health, one gets aware that the different possibilities to practice
the medical profession are getting ever more narrow thanks to limitations,
incompatibility and exclusive employment relations with the National Health
Service. It must be taken into account the situation is rising for the single
physician, economic level.
The problem regards both contracted for physicians and those working within
National Health Service, both professionals and those having professional
collaboration by contracts of real underemployment.
All physicians who, with the continuous reduction of professional outlet,
besides being affected by the shrinkage of their own current fees, will find
the inevitable consequences of this situation also regarding the retirement
pensions. We could say that the actual retired physicians situation is rosy
with respect to those that next years must be given pensions dimensioned to
current contributions, limited both in relation with the magnitude of contributions,
reported to a mono-income ever more reduced, and with the contribution seniority,
even this very limited both entered in the credit side (due to the medical
plethora) and in disbursements (due to the ever lower age limits).
Let's make an example regarding a general medicine physician, 70 years old,
already working within national health service at the times of the several
health insurance institutes and whose relation was featured by payments per
service: that physician has accumulated contributions for the practice he
has formerly carried out since he was 26 years old when the limits of liability
were high and furthermore differing by institutes.
By the means of the contribution revaluation, along the 44 years of practice,
that physician can enjoy today a good pension treatment. Instead nowadays
among apprenticeship for general medicine, regional lists and number of candidates,
physicians do not succeed entering the general medicine list before they are
35 years old. The institutes' unification will not allow them to reach those
fees and those security contributions that have allowed the Enpam to pay the
current pension treatments.
To all that it is to add that the Ministry of Health has already announced
further age limitations and limits of liability, bringing the result that
the physician must stop practice when he will be 65 years old having a contribution
seniority of only 30 years, being contributions ever lesser, involving a mathematical
result of an ever more modest pension. Even the eventual onerous supplement
for the university education will not allow great security revaluation.
On the other hand lately it has been introduced remarkable limitations into
the security legislation so that both the reversionary pension in favour of
survivors and the revaluation of pension on Istat index basis have been reduced
drastically since related to the possession of other incomes. It has been
introduced heavy reductions in pension payment whenever there's professional
work practice at the same time.
All that independently from the fact that the amounts paid have been withheld
to everybody applying the same contribution rates and rights must be the same,
and so apart from the possession of other incomes or the practise of professional
work. Furthermore it's in course a signature collection supported by the Health
Pensioner and Widows National Federation (FEDERSPEV) for a popular bill siding
a series of bills already submitted to Parliament by several deputies to abrogate
the part of the Law 8/8/95 introducing these rules about the aggregation of
incomes and pensions. In exchange it is being drawing up a government decree
modifying substantially all norms about the deductibility of the social security
contributions fiscal level.
Indeed since 1999 (2000 income-tax return) it will be possible to deduct from
the taxable income, besides the obligatory social security contributions at
whole, also contributions for private security in a measure decisively higher
than the 2.500.000 current lire, the upper limit to add up quite completely
insurance and private security contributions and those regarding ransoms.
All that will contribute to give future pensions a further chance to achieve
an own additional pension treatment even if by the means of private security
payments that being deductible substantially from the taxable income, will
charge decisively less than the current private security contributions. It's
evident that with these outlooks, Banks, Insurance Companies and Financial
Institutes are readying appealing proposals for additional pensions on the
base of the new fiscal norms in view of the crunches that the Social Security
Institutes - and mainly the legislation trending to level ever lower the current
social security treatments - have prepared for us in the next future.
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