" Who asks to centralize tut to
in reality it does not save,
but to move
balances the current decision. "
--------
The Catholic life
Weekly Friuli
Archdiocese of Udine
Friday, January 28, 2011
BEWARE The false
HUNTERS OF WASTE
Editorial Roberto Think
For Regional Health is the time to do a 'cut'. , said the Regional Minister for Health, Vladimir Kosice, explaining Tuesday, January 25 at the third regional advisers Commission management guidelines in 2011 that network services should ensure that all pre prevention and appropriate treatment. now for 30 years now, when someone proposed to make a 'cut' or a revision of health, means that there is going to cut something . The problem of resources, explained the same sore asses, is central: "Every 15 years, we need to do the cutting, to improve a system that can not stand still, because you can not spend like 15 years ago. " On the other hand, the data speak for themselves.
In 2001, the regional health expenses am montava ad 1 miliardo e 365 milioni di euro. Nel 2010 è arrivata a circa 2 miliardi e 245 milioni. Insomma, manca un soffio al rad doppio, nonostante tutte le misure di contenimento della spesa e della durata delle de genze applicate nel decennio. Ben di più dei tassi di inflazione, segno dei bisogni di salu te sempre più complessi di una popolazione che invecchia, ma anche spia di una cre scente applicazione di tecnologia che, se da un lato consente risultati di eccellenza, dal l'altro assorbe una gran quantità di risorse.
Questa volta l'approccio ai «tagli» sembra essere più soft, ancorché potenzialmente non meno doloroso. Non si usa la «man naia» per tagliare interi ospedali, come ne gli anni '80 e '90, ma il cesello per valutare i volumi di attività di ciascun nosocomio e struttura sanitaria territoriale e comprendere come siano strutturate, all'interno di ogni Azienda, le aree dirigenziali, per anda re a snidare gli sprechi.
Non tutte le «razionalizzazioni», però, rappresentano una semplice «sforbiciata» inefficiency. is therefore vital that the public and local governments (provinces and municipalities) should take the high attention them about what's happening in health care on the territory river, especially the most penalized (like mountain) or peripheral.
Particular atten tion it deserves, certainly, a proposal already advanced at the time of the previous junction ta regional led by Riccardo Illy, but still maintains a wide range policy cally cross supporters: the creation zione di un'unica azienda socio-sanitaria per tutto il Friuli-Venezia Giulia. Tant'è che proprio prima che Kosic prendesse la parola, alla terza commissione era stata presen tata una proposta di legge in tal senso da parte dei consiglieri del Pdl Dal Mas e Pedi cini.
A prima vista è una proposta accattivante : se bisogna risparmiare, perché non partire dal «pletorico sistema vigente, strutturato tra pubblico e privato su 18 aziende»? Pertanto, hanno sostenuto i proponenti, «l'obiettivo è la riqualificazione organizational and administrative structures of the regional health service, aimed at recovery perare resources to improve the quality of Services.
But there is something wrong . Innana zitutto know that there is now strong imbalance in the allocation of funds, the Tondo junta has pledged to balance (albeit on a very long time). For a city of Trieste, is spent annually for health 2550 €. If you live in the province of Udine has available to only 1933, and be worse in Pordenone (1724 €) and especially in Gorizia (1628) . Dalla Venezia Giulia defend themselves by saying that there, the population lation is older and has more neces sity. But we understand that the underlying reason is an excessive centralization historic ser vices in Trieste, which you can not (or do not want ) cure.
The point is this: today know this information because the territory regional is divided into six health care companies, each with its own budget. Tomorrow, with a unique company, the allocation of resources would be so transparent, even still evil?
The second reason is perhaps more philosophical, though no less important. Old USL originated as organisms in which the insti local institutions (primarily municipalities) dictated no priorities in health policies. It was an exaggeration and excessive weight of the policy generated enormous waste. With a ziendalizzazione has tried to strike a balance between the weight of politics and the needs of a ze a technocratic management based on principles of efficiency. But tomorrow, in front the management of a company health Royal tion only, which listeners can find such as mayors and citizens of the Car nia or the Natisone Valley?
Experience shows that most decision-makers will Allon tanano geographically, the greater the ab abandonment of the territory.
Today telematic management technologies make it possible to rationalize many functional tions without necessarily having to unify all cen tri decision .
Who asks to centralize tut to (health, but similar proposals have been made for University, for Erdisu, for Chambers of Commerce ...) does not do it reality to save money, but to shift the balance of decision-making force.
Fortunately, the bill on the company health nemme not only do not like the majority of the PDL. Košice is the tooth taken Tondo are much more cautious, although una corrente nel centrodestra vorrebbe ri durre a 3 le Ass regionali. Il Friuli, comun que, deve tenere gli occhi ben aperti se vuole ricevere quello che gli spetta nella corret ta impostazione di un federalismo solidale tra le diverse realtà territoriali che compon gono la Regione.
Roberto Pensa
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