In the critical weeks before the end of the year, work on the text of Budget Law Enter the decision stage. If the approval hours are not respected, the concrete risk we face is a temporary operation, which imposes strict restrictions on management. Public expenditure by the executive.
And it is public spending in particular that is the focus of attention. As is well known, Maneuver It is a complex text that explains. Income and Expenditure of the State and makes key interventions on taxes, investment, welfare and economic policies. In the text we obviously find a chapter related to this. Expenditure on Health Care and Administration of National Health Care System – SsnThe highest demand for state resources
According to trade unions and opposition parties, Budget Law 2025 This would confirm the reduction of allocations to public health services in favor of private health care. It is no coincidence that there has been no shortage of it in Parliament in recent times to fight Refinancing the National Health Fund, guaranteeing health services to the less healthy and protecting the individual right to health.
Hence the recent Decision of the Constitutional Courtthe n. 195 Last December 6th, takes on an important significance. It has been said that the objective of containing public expenditure, linked also to the constraints of the European Union, cannot be overlooked. Health care costs. Cuts in the sector should be the result of a careful assessment, with no allowance for “in the dark” choices.
Let’s take a closer look at this interesting commandment, which also seems to be a guide for related work. Strategy 2025Which has now reached the final stages.
The constitutional validity decision was activated by the Campania region.
The decision of the Council is based on this. Decision on constitutional validity Regarding art. 1 – Paragraphs 527 and 557 – of the latest budget law (forecast of the state budget for the fiscal year 2024 and the multi-annual budget for the three-year period 2024-2026).
The decision was promoted by The region of Campania With an appeal last February, it was pointed out that the aforementioned paragraph would have violated the plurality of articles of the constitution, for example. The principle of equality, the sphere of competence of local authorities and the basic principles of the state budget.
The regional administration was aiming to – among other things – request the state regions to spend 350 million euros a year to cover public health care. In case of non-compliance, the same budget law imposed a penalty on the institution, which would have faced cuts in state resources, including for local health care.
Specifically in the text of the 2024 budget it was written that:
For the purposes of safeguarding the economic unity of the Republic, taking into account the needs involving public expenditure and in compliance with the principles of harmonization of public finances. […] For each year from 2024 to 2028, common law regions ensure a contribution to public finances equal to 350 million euros per year.
Above all, what was contested was the prediction that State General Accounting Department Along with this, steps will be taken to recover the unpaid amount. Reduction of due resources In favor of the default region.
Local health care should not be cut if it is possible to reduce other costs.
Consulta only partially accepted these issues. The region of Campaniato constitutionally invalidate Art. 1 Paragraph 527, fifth sentence, of Strategy 2024in the part in which it is not excluded from the resources that it is possible to reduce the amount owed to finance social rights, social and family policies, but Health protection.
Generally, the ruler considered the reduction of resources in case of non-compliance consistent with the constitution. Responsibilities in the field of public financebut – at the same time – established that the state cannot indiscriminately “cut” certain regional allocations to areas of social relevance and constitutional importance such as health care and health protection.
Indeed, the text of the Council’s provision makes clear that:
In the context of Scarce resourcesTo meet the needs of Public expenditure restraint Also ordered by Restrictions of the single euroOther unclear costs should be reduced as a matter of priority, compared to what is characterized by being active to guarantee “.Fundamental right to health I referredArt 32 Cost., which also calls into question the necessary conservation requirements. Weaker sections of the populationThe so-called expenditure incurred directly by the citizen is not accessible. Out of pocket.
And this is even more so – explains the Court – if we bear in mind its own comprehensive jurisprudence which criticizes any legislative practice which Very inclined to act on it. Constant linear deduction. (Sentences No. 63 of 2024 and No. 220 of 2021) also with regard to health care, and which worsened the quality. Local Health Service Overall, those who particularly suffer the consequences are those who cannot afford health care and services through direct costs and private consumption.
Fondo Test next-generation sequencing
Furthermore, the court, encouraging mutuality between the state and the territories, declared the constitutional invalidity of paragraph 557 of Art. 1 of Budget Law 2024In the part in which it is not estimated that Decree of the Ministry of Health – on the distribution and monitoring criteria of the “Fund for Next Generation Sequencing Tests for the Diagnosis of Rare Diseases” – adopted in accordance with the Permanent Conference for Relations between States, Regions and Autonomous Provinces and Trento. Bolzano.
In addition to regional contributions but with certain conditions
As mentioned above, with sentence no. 195, the Council – however – considered the questions regarding the validity of the document to be unfounded. Contribution of regions to public finance purposesEstablished by the 2024 budget law, this procedure actually fits into the context of the new. Governance The EU and – indeed – the state legislature tried to prevent the contribution in question from affecting the expenditure related to Mission 12 (Social rights, social policies and the family) and Mission 13 (Health protection), which in the order Reference is made.
However, this does not mean that common “cuts in the dark” should be avoided. The Constitutional Court actually took the opportunity to remind the legislature:
- Collect appropriate data on Durability of partnership Areas requested;
- add Permanent Conference for the Coordination of Public FinancesTo strengthen the principle of faithful cooperation (as provided in Art. 5 of 2009 of Law No. 42).
What changes?
Joomla No. 195 fixed one Health Guarantee ClauseA clear reference also to those who are responsible for the draft. Budget Law 2025. In fact, the Court has established the principle that protection of health – as stated in Art. 32 cannot be subordinated to the Constitution Accounting logicbut must always and in any case be considered as the main and inspiring motive. Laws and regulatory acts in general.
for the court, Health Care Purpose AllocationHaving already been sorely tempted by previous large-scale cuts, no more sacrifices can be made if there are other areas of spending that can be cut. It is therefore certainly true to reduce expenditure and reduce the deficit-GDP ratio in order to have a balanced public budget – especially in the context of limited resources such as the Italian one – but first the general, non- By following the basic costs and not intended. Protecting and safeguarding the interest of the community The most vulnerable group of the population
It is true that Underfunding of the health sector It lasted for ten years and led to a progressive. Shortage of medical staff and doctors (and envisioned a crackdown on on-call services), endangering and preventing cuts to the capacity and quality of public services. Social inequalityEspecially in the southern regions.
Therefore, the Court’s decision points to the way forward and reiterates: the state should not take the right to reduce the resources allocated to health care, even if the Regions have included public finances in the 2024 budget. I have not paid my share.
Budget Act of 2025, Appropriations for Health Care
On the subject of local public health resources, the decision of the judges in Piazza del Quirinale offers a direction that cannot be ignored, a clear division between basic and constitutional health costs and other costs of less importance to the community. Establishes a line.
With the approval of the Chamber Strategy 2025 It is now virtually certain, only confirmation in the Senate, expected after Christmas, is missing. Regarding health care, total financing on the evening of Friday 20 December 136.5 billion euros For the following year and – specifically to address the issue of waiting lists – 0.5% of costs for the year 2025 and 1% starting in 2026 for the purchase of health care services from approved private institutions. Further increase is expected.
Whereas, a limited quota equal to 50 million euros per year starting from 2025, should be limited to new financing. Required levels of support – Lea. To combat the lack of medical service capacity, the budget law also provides that all health care workers who choose to do so will be able to stay in service for up to 70 years.
In recent weeks, there has been criticism from the opposition, and so have the unions. There CGIL He called for the National Health Fund to reach 7.5% of GDP, to speed up NHS recovery. While in the recent hearing The Gambia Foundation Discussions took place in the joint budget committees of the House and the Senate. Insufficient resources Restoring the aforementioned fund and financing all measures envisioned in the 2025 budget law — work on which has recently accelerated to meet the deadline.
On the other hand, also on the subject of public health, Each change must be carefully evaluated to ensure consistency – and above all national and European budget constraints (such as compliance with the Stability Pact). And a sentence like the one seen above is certainly enlightening.
However, the confirmation of expenditure on the plate may not represent a fig leaf, postponing the necessary financing or further cutting investment in the sector.
