Table of content 1. Preface .......................................................................................................................... 1 2. Background .................................................................................................................. 2 3. Executive Summary .................................................................................................... 3 4. Methodology and purpose ......................................................................................... 5 5. Political and economic outlook ................................................................................. 5 6. The recommendations of the “Wise Men” ............................................................. 8 7. The Italian election February 2013 .........................................................................10 7.1 The PD´s election results .........................................................................................11 7.2 The PdL´s election results .......................................................................................12 7.3 The Radical Left’s election results ..........................................................................13 7.4 The Scelta Civica per l’Italia´s election results ......................................................13 7.5 The Movement 5 Stelle´s election results ..............................................................14 7.6 The Political evolution .............................................................................................15 8. Programmes of leading parties ................................................................................16 8.1 Popolo della Libertà ..................................................................................................16 8.1.1 PdL’s main healthcare issues: ..........................................................................17 8.2 Fratelli d’Italia – Centrodestra Nazionale ..............................................................17 8.2.1 FdI’s main healthcare issues: ...........................................................................18 8.3 Partito Democratico .................................................................................................18 8.3.1 PD’s main healthcare issues ............................................................................20 8.4 Centro Democratico .................................................................................................20 8.4.1 CD’s main healthcare issues: ...........................................................................21 8.5 Sinistra Ecologia e Libertà .......................................................................................21 8.5.1 SEL’s main healthcare issues:..........................................................................23 8.6 Scelta Civica per l’Italia.............................................................................................24 8.6.1 SCpI’s main healthcare issues: ........................................................................26 8.7 Lega Nord ..................................................................................................................27 8.7.1 LN’s main healthcare issues: ...........................................................................28 8.8 Movimento 5 Stelle ...................................................................................................29 8.8.1 M5S’s main healthcare issues: .........................................................................31 9. New healthcare programming of the MOH .........................................................32 9.1 Prevention ..................................................................................................................32 9.2 Reorganization of the Health service network .....................................................34 9.3 The LEA .....................................................................................................................34 9.4 The New Agreement for Health (Nuovo Patto della Salute) .............................34 9.5 National Health Fund ...............................................................................................34 9.6 Patient co-payment (ticket) ......................................................................................35 9.7 Initiatives on cross-border care ...............................................................................35 10. Healthcare focus group ............................................................................................35 10.1 The underlying issues of the focus group ..............................................................36 10.1.1 The Sustainability of the funding system ......................................................37 10.1.2 Spending cuts ....................................................................................................38 10.1.3 Federalism within health ..................................................................................40 10.1.4 Access to healthcare services ..........................................................................41 10.1.5 Innovation and sustainability ..........................................................................43 10.1.6 Ageing and the policy for the elderly .............................................................44 10.1.7 Integration of private funds ............................................................................45 11. The focus group and key findings ..........................................................................47 12. Healthcare interviews ...............................................................................................50 13. References ..................................................................................................................56 14. Appendices .................................................................................................................57 14.1 Appendix 1: Statistics related to the results of the elections ..............................57 14.2 Appendix 2: Health Legislation from 2011-2012 .................................................62 14.3 Appendix 3: Additional recommendations of the 10 Wise Men .......................63 14.4 Appendix 4: Government profiles of the XVII legislature .................................69 14.4.1 President of the Italian Republic – Giorgio Napolitano .............................69 14.4.2 President of the Council of Ministers – Enrico Letta .................................69 14.4.3 President of the Senate – Pietro Grasso ........................................................70 14.4.4 President of the Chamber of Deputies – Laura Boldrini ............................71 14.4.5 Minister of Health – Beatrice Lorenzin .........................................................72 14.5 List of deputies coming from the health sector – XVII legislature ...................72 14.5.1 Physicians ...........................................................................................................72 14.5.2 Veterinarians ......................................................................................................75 14.5.3 Pharmacists ........................................................................................................75 14.5.4 Biologists ............................................................................................................76 14.5.5 Psychologists .....................................................................................................76 14.5.6 Healthcare professionals ..................................................................................77 14.5.7 Others who have held positions in the health sector ..................................77 14.6 Senators coming from the health sector – XVII legislature ...............................78 14.6.1 Physicians ...........................................................................................................78 14.6.2 Veterinarians ......................................................................................................82 14.6.3 Pharmacists ........................................................................................................82 14.6.4 Biologists ............................................................................................................82 14.6.5 Healthcare professionals ..................................................................................83 14.6.6 Social workers ....................................................................................................83 14.6.7 Clerical workers .................................................................................................84 14.6.8 Others who have held positions in the health sector ..................................84 14.7 The Italian Government – XVII legislature..........................................................85 14.8 President Giorgio Napolitano’s Opening Speech ................................................97 The making of this report came about shortly after the resignation of the now former Italian Prime Minister, Mario Monti, and the elections in the spring of 2013. The Italian public healthcare is at risk and urgent measures are needed for the sustainability of the healthcare system. The new government has to balance budgets and restrain spending, while upholding investments in prevention and improved treatments. It has to impede the increase in social costs that