Chapter 2

in the light both of the effects of socio-economic conditions on utilisation and of the different
Regional co-payment impacts;
■ The persistence of a significant share of out of pocket expenses should encourage the
search for incentives for supplementary insurance solutions: there is a clear necessity to
use targeted incentive systems both on the revenue side (to broaden the number of subscribers),
and on the side of provided coverage, in order to avoid a merely duplicative role
of the policies;
• The system still suffers lack of effective interventions in selected areas: this year we cite
the mortality gap that affects women from the south and from the islands, particularly in
the area of tumours for which organising Regional screening is mandatory. Gender disparity
is confirmed by the concentration of avoidable mortality on women;
■ Apart from inefficiency problems existing in the southern local health authorities, there
is also a clear necessity for strong commitment in order to modify customs and lifestyles
at risk, in particular amongst southern women;
• Italy has a passive international health mobility (more people go abroad for treatment
than come to Italy for it), except in few selected Regions. The challenge of providing
“health tourism” services, reversing this balance, would be a good conclusive test on our
capacity to supply quality services;
• And finally, indirect benefits must not be forgotten in terms of value-added, research,
social cohesion and human capital created in the health care sector. In this respect we
observe a positive correlation between average size of firms and positive balance of
exchange trade, suggesting urgent industrial policies in the sector;
■ Industrial development policies and those of cost containment should go hand-in-hand,
for example ensuring the sort of regulatory stability which is necessary for industries to
flourish.
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CEIS Health Report 2006