The national health services, all of them, have to deal with the economic sustainability of the services provided. And this sustainability is based on two pillars which are the wealth of each country and the way resources are used. However, the aging of our populations and the growing costs of new therapies are a knot that we must all quickly untie.
In 2020, our public health spending per capita was $2,851. In the same period (2018-19) the value of health expenditure compared to GDP had decreased by 0.2%. In comparison, the per capita expenditure of a German citizen was $5,905, that of a French citizen $4,632 and $4,158 for a British citizen. Spending relative to their GDP had increased by 2 percentage points. In summary, our health expenditure, with the exception of the Covid period, stood at around 7.1% of GDP in 2021 while our neighbors spent more than 10% of GDP. Perhaps Germany, France and England make health policy choices different from ours or have economies that allow for these choices. Our accounting magistrates, however, believe that the Italian governments have preferred to allocate the few resources available to "another" and that the protection of health must be reconciled with the balance of public finances.
But we are not alone in Europe. A few days ago in Madrid, 250,000 people took part in a massive demonstration in defense of Spanish public health. The mobilization demanded better basic health services, above all due to access difficulties, a halt to the privatization of services, especially in rural centres, and strongly contested the cuts in health resources decided in recent years. Our glorious health services need new blood, new ideas, greater citizen involvement. Because while on the one hand we all have the right to be treated, on the other hand we must commit ourselves to maintaining good health. And to move from words to deeds, it is necessary to look at facts, at scientific knowledge and enter into a new pact with citizens because healthcare based only on the treatment of diseases will have unsustainable costs. Let's talk about what we know and what can be done, that is, to prevent cardiovascular diseases. Hypertension is one of the main risk factors for cardiovascular disease (ischemic heart disease is the leading cause of death worldwide). About 30% of our fellow citizens are hypertensive, especially 56% of men and 43% of women aged 35-79 are hypertensive. Blood pressure is the most important risk factor for stroke, myocardial infarction, peripheral arterial disease, chronic renal failure, retinopathy. If we add obesity and smoking to this risk factor, we have covered the spectrum of correctable factors capable of lengthening life and preventing cardiovascular disease. But a little effort with the use of salt is enough. Maximum three grams of salt a day in addition to that present in food to reduce blood pressure and have good health. We need a project that revolves around the general practitioner. Their patients should have their blood pressure and weight measured at agreed times. All should be given a brief visit to assess whether there is damage to the arteries and a form filled out for checkups over time. It's not that difficult to structure this project, our lives and a better future for our health service depend on it. Not getting sick is also good for the health service.
Antonio Barracca
