Italian Healthcare System in the Global Context: The Cultural Challenge of Predictive, Preventive and Personalized Medicine

Abstract

Italy has a public healthcare service for all the residents called “Servizio Sanitario Nazionale” or SSN (National Health Service) which is similar to the UK National Health Service. It is publicly run and funded mostly from taxation: some services requires small co-pays, while other services (like the emergency medicine and the general doctor) are completely free of charge. The general policy directives are toward a positive evolution of healthcare system in Italy, along the line of the most appreciated supranational, independent health organizations. Nonetheless, the excessive drive of management and government, centered on the processes and on the efficiency of systems, not adequately related with reliable outcome indexes, contributes to increasing costs without proportionate perceived and actual benefits. The macroscopic bug is in the medical doctors’ professional autonomy, i.e. there is a defective operative efficacy in affordable and mostly important skills and knowledge applications. A greater clustering of knowledge and skills in medical profession, comprehensive of dietary/physical exercise assessment and prescription, and enhancing the point-to-care diagnostic competences of all medical doctors is recommended. Widespread and affordable diffusion of ultrasound competences and facilities, training in life supports and essential procedures (also by friendly e-applications, e-learning and simulation theater tools) will allow a sustainable process of predictive, preventive and personalized medicine. By this, consistent screening, diagnosis and follow-up activities of healthy and unhealthy groups and populations will be realistic. This is the economic and cultural challenge of predictive, preventive and personalized medicine that will allow to realize a more advanced and effective healthcare system scenario in Italy and in a global context.