Data di Pubblicazione:
2011
Citazione:
Pensions, Health Care and Long-term Care in Italy / M. Jessoula, E. Pavolini. - [s.l] : Analytical Support of the Socio-economic Impact of Social Protection Reforms (ASISP), 2011.
Abstract:
Executive Summary
In the period covered by this report (January 2010 – May 2011) developments have been
rather different in the three social policy sectors of pensions, health care and long-term care.
In the field of pensions, recent reforms of the public pillar have mostly dealt with eligibility
conditions for both old-age and seniority benefits. In particular, the link of both age and
contribution requirements with changes in life expectancy has represented a major step
forward in aligning the Italian pension rules with recommendations by the EU.
In spite of the relevant changes recently legislated, the pension debate in Italy has not been
particularly intense in 2010 and the early-2011 and policy proposals have pointed at (more or
less) limited adjustments to the existing pension architecture. This is the consequence of
various factors, among which i) the important reforms already adopted in the 1990s-2000s, in
combination with, ii) the widespread consensus among politico-institutional and social actors
on the need to continue on the path of fiscal consolidation, and iii) the fact that the 2008-9
financial crisis did not have a disruptive impact on supplementary funded schemes which are
still in their infancy. Especially concerns regarding the sustainability dimension of the public
pension system have been very limited; by contrast, several contributions have stressed the
risk of inadequate old age protection in future decades as a result of the interplay between the
“dual” labour market and the emerging multi-pillar pension system based on NDC plus DC
schemes.
In a comparative international perspective the Italian NHS seems to function relatively well
and the reforms undertaken in the last years seem to improve this functioning. The different
laws and agreements passed since 2010 try to focus on different aspects of the NHS (from
specific relevant issues, such as palliative care, to more general ones, as prevention or
oncological care). Overall the system seems to be improving, but there are very serious
problems that can blur this general picture: social inequalities between individuals and
households with different income levels in the access to health care; territorial inequalities in
the access to decent health care (the North-South divide); from this point of view it is not
clear what the impact of a broader regionalisation of the NHS will be thanks to federalism; a
still too weak system of integrated social care and health care for chronic diseases; a
forthcoming shortage of medical professionals.
Apart from more strictly health challenges (how to cure cancer better, cardio-vascular
diseases, etc.), the four issues just quoted represent the main worries for the future of the
Italian NHS: the developments from 2010 have not shown many improvements in this
respect.
In comparison to health care, there was not too much policy innovation in the long-term care
(LTC) field. Also the Italian public LTC seems to show to different “sides”: one positive, the
other one more problematic. The positive one is represented by the fact that today more than
10% of the elderly do receive some form of public coverage for their LTC problems. This
level of coverage is not distant or different from the ones typical of many other Western EU
countries. The more problematic side is related to the fact that this coverage comes mainly
from cash programmes and less from the delivery of services. The fact that the system is cashbased
(and it is increasingly so) has three effects, strongly linked with each other: still a lot of
pressure and responsibilities are on family carers’ shoulders; a private care market (quite often
“grey” and made by migrant women) has developed tremendously in the las
Tipologia IRIS:
08 - Relazione interna o rapporto di ricerca
Keywords:
pensions; health care; long term care
Elenco autori:
M. Jessoula, E. Pavolini
Link alla scheda completa: