A decrease of over 3.6 billion in 2023 compared to the previous year, followed by an increase of 7.6 billion in 2024, which however "is only illusory, as it is largely due to the fact that it has not been perfected the renewal of the contracts of managers and contractors for the three-year period 2019-2021, the costs of which were not recorded in 2023 and were postponed to 2024". It is the Gimbe Foundation, with its president Nino Cartabellotta, who carries out an independent analysis of the data on health spending contained in the 2024 Economic and Financial Document, which, in addition to the 2023 final budget, also includes the estimates for 2024 and for the three-year period 2025-2027.
"Compared to the health spending forecasts up to 2027 - states Cartabellotta - the Def 2024 attests to the lack of a change of course and ignores the terrible 'state of health' of the National Health Service (SSN), whose fundamental principles of universality, equity and justice have been betrayed, with consequences on people's lives, especially the weakest socio-economic groups and the populations of Southern Italy.
From very long waiting times to unacceptable overcrowding in emergency rooms; from regional and local inequalities in the provision of health services to the migration of healthcare from the South to the North; from the increase in private spending to the impoverishment of families up to the renunciation of treatment". If the Def certifies a health expenditure/GDP ratio of 6.3% in 2023 (compared to 6.7% in 2022) and a health expenditure of 131 billion in absolute terms (over 3.6 billion less than in 2022), in 2024 the health expenditure/GDP ratio will rise to 6.4% in 2024 compared to 6.3% in absolute terms; healthcare of over 138.7 billion, i.e. 7.6 billion more than in 2023 (+5.8%), a figure which, however, Cartabellotta notes, is only 'illusory'.
In the three-year period 2025-2027, compared to an average annual growth in nominal GDP of 3.1%, the 2024 Def estimates the average annual growth in health spending at 2%. The health expenditure/GDP ratio is reduced from 6.4% in 2024 to 6.3% in 2025-2026, to 6.2% in 2027. Compared to 2024, in absolute terms health expenditure in 2025 rises to 141.8 billion (+2.2%), to 144.7 billion (+2.1%) in 2026 and to 147.4 billion (+1.8%) in 2027.
"Considering that the Def in "simplified" form does not contain indications on the economic policies for the next Budget Law - comments the president of the Gimbe Foundation - while on the one hand the forecasts for the three-year period 2025-2027 confirm the progressive decline in the health expenditure/ GDP, on the other hand, further reductions in health spending cannot be ruled out given the very narrow margins to deficit finance the next Budget. In this sense, the absolute estimates of 6.4 billion more in 2025 and 9.1 billion remain very risky. billion in 2026, taking into account that the National Health Requirement set by the 2024 Budget Law is equal to 135.4 billion for 2025 and 135.6 billion for 2026".
"The Def 2024 confirms that, in line with what has happened in the last 15 years, public health does not represent a priority at all, not even for the current Government", continues Cartabellotta, recalling that the NHS Relaunch Plan developed by the Gimbe Foundation "proposes to progressively increase healthcare spending, with the aim of aligning it to the average of European countries by 2030, in order to guarantee the relaunch of healthcare personnel policies, the uniform provision of Essential Levels of Care and equitable access to innovations ". According to Cartabellotta, "the pandemic has taught nothing at all. In fact, the persevering public defunding will increase the distance with European countries and will definitively sink the NHS, compromising the constitutional right to protect people's health, in particular for the less well-off classes and for residents in the Southern Regions".