Why were health sector workers angry at the budget law?

One of the most discussed topics in the budget law concerns the additional money that will be allocated in 2025 to the National Health Service, which has been under-resourced for some time. Compared to the statements of government members and the expectations of Health Minister Orazio Schillaci himself, the numbers were somewhat lower. As of Tuesday, around 3.5 billion euros were expected to be saved for next year. It was then published on Wednesday morning Budget planning document – The summary form to be sent to the European Commission for the draft budget law, the text of which is not yet available – turns out that the expected additional budget does not even amount to 900 million euros. For this reason, the opposition and numerous associations representing the healthcare sector attacked the government.

The misunderstanding arose from the fact that the government had said for weeks that the money for healthcare would come from the controversial tax on banks’ “extra profits” and from increased insurance taxes, which would have brought in €3.5 billion. But not only will this tax likely not be a real tax in the end, but the amount is also expected to be in two years: in fact, it is spread out over two years on health care, according to the budget plan, at about $900 million a year. 2025 and 3 billion in 2026 (obviously there will also be integration from other funds).

In short, there appears to be an accounting misunderstanding. Today some newspapers write that this division was not known to Minister Schillaci himself, who in previous days had often spoken publicly about a figure of around 3.5 billion euros for 2025 alone. Shortly after the Cabinet approved the draft budget bill on Tuesday evening, all From Transport Minister Matteo Salvini and Prime Minister Giorgia Meloni on social networks expressed their satisfaction with their ability to refinance healthcare with the billions that will come from the measures imposed on banks and insurance companies.

On Wednesday afternoon, the Ministry of Economy and then later He explained Noting also the amount of new funding: the figure indicated in the budget plan – $900 million, equivalent to 0.04 percent of GDP – will aim to finance net increases in medical staff salaries, which, however drastic, amounts to €1.245 billion.

This is therefore the total figure allocated this year for 2025, to which must also be added the billion already expected in 2023 under the previous budget law: a total of an additional 2.3 billion euros, which will raise the National Health Fund from 134.1 billion euros to 134.1 billion euros. 136.4 in 2025. The National Health Fund is what the state gives to the regions each year to finance health care, but public spending on health care is slightly higher, and the rest is financed through co-payments and through debt: at the end of 2024, 138 billion will be financed, It was already expected to increase by 4 billion in 2025.

Thanks to new government funds, it will rise to more than $143 billion: roughly 6.3 percent of next year’s expected GDP, an insufficient level and below the average for European countries.

Associations of healthcare workers, doctors and sector observers are disappointed by the amount of resources, but also by the decision to distribute a significant part of the funds in 2026: financing the expected plan to employ more than 30 thousand new people is therefore very difficult. Postponed among doctors and nurses, as well as all interventions to increase their salaries.

Nino Cartabellota is the President of the GIMBE Foundation, an important research center on health issues

Italian healthcare has been struggling long before this government took office. OECD, the OECD that monitors, among other things, the economies of Western countries, publishes a report every year. relationship On the health systems of member countries: the latest, for 2022, shows that Italy spent 6.8 percent of its GDP on public health (a figure equal to 2,208 euros per inhabitant on average), compared to 10.3 percent of Italy’s GDP. France (3,996 euros per inhabitant), 10.9 percent of Germany (5,085 euros per inhabitant), 9.3 percent of the United Kingdom (3,409 euros per inhabitant), 7.3 percent of Spain (2,041 euros per inhabitant). Not only does it spend less than the most virtuous countries, but it is also less than the average of the European countries concerned, equivalent to about 7 percent.

Compared to 2022, the situation has worsened. The Structural Budget Plan, the new fiscal document envisaged by a reform of European rules on state budgets, shows that in 2023 public health spending fell to 6.2 percent of GDP, before rising to 6 percent in 2024.3, the level Which was set by the government and decided to also maintain the year 2025 with the new allocations. From 2026, it is not yet clear what will happen: the structural budget plan expects health spending to fall again to 6.2% compared to GDP, but this figure does not take into account the interventions of this budget law.

Meloni has repeatedly claimed to have raised National Health Fund allocations to an all-time high, which he also did on this occasion: indeed that is the case, but we are talking in absolute numbers. However, health care spending is struggling to keep up with the overall growth of the economy, which is the criterion that must be evaluated to understand how much income a country produces in a year is used to fund health care.

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