Italy's healthcare sector is facing significant challenges due to a payback system that has been extended to medical devices. This system, originally designed to cap public spending on medicines, now threatens the financial stability of healthcare companies, particularly in regions like Marche.
The payback mechanism requires healthcare suppliers to reimburse a portion of their earnings if regional spending exceeds a predetermined ceiling of 4.4 percent of the ordinary health fund. This policy has been criticized for shifting public debt onto private companies, penalizing them for exceeding budgetary limits that may not account for the necessary levels of care.
The Constitutional Court recently upheld the constitutionality of this measure, despite appeals from companies in the sector. In the Marche region alone, over 40 companies are expected to contribute 136 million euros, exacerbating the financial strain on local healthcare providers.
The repercussions of the payback system extend beyond financial metrics; they pose a direct threat to the availability of medical disposables and healthcare services for patients. As companies grapple with reduced resources, there is a growing concern that they may be forced to cut back on essential services, compromising patient care.
Natali emphasizes that the current system could lead to a significant decline in the quality of healthcare services, as companies struggle to maintain adequate supplies and operational capabilities.
Moreover, the payback mechanism disproportionately affects smaller, less structured companies, which may find it increasingly difficult to survive in a competitive market. A study by Nomisma highlights that these companies are more vulnerable to the financial pressures imposed by the payback system, potentially leading to a wave of market exits.
In light of these challenges, Natali advocates for a reevaluation of the payback system and its implications for the healthcare industry. He suggests that a national program should be established to facilitate a transparent and centralized selection of medical technologies, ensuring that only safe and efficient devices are procured.
This approach would not only enhance the quality of healthcare but also provide greater oversight of public spending, eliminating outdated technologies that fail to deliver a balance between clinical benefit and economic efficiency.
To address the financial strain on healthcare companies, Natali proposes two critical reforms. First, he calls for improved monitoring of the spending ceiling, integrating this oversight into the performance objectives of healthcare company directors. This would help prevent budget overruns and ensure that financial resources are allocated more effectively.
Second, he urges a revision of the spending ceiling to align it with European averages, providing a more realistic framework for healthcare funding that can support both innovation and patient care.
As the healthcare sector navigates these challenges, the need for strategic oversight and reform has never been more pressing. The current payback system, while intended to control public spending, may inadvertently jeopardize the very fabric of healthcare delivery in Italy. Stakeholders across the industry must come together to advocate for changes that prioritize patient care, support innovation, and ensure the long-term viability of healthcare providers.