OREvery year, on December 12th, the International Universal Health Coverage Dayan event established by the United Nations in 2012 which aims to reiterate the importance of the fundamental right to promote concrete actions to reduce inequalities in access to care. Despite the progress made, achieving the objective remains a challenge that has not yet been overcome. And it calls into question one of the fundamental principles enshrined in the United Nations, viz access to care as a universal right and not as a privilege.
Universal Health Coverage, a fundamental right
There Universal Health Coverage It is crucial to ensuring that all people, but especially the economically disadvantaged, can access the quality care they need, without further impoverishing themselves.
Unfortunately, however, this is not the case: in the last 20 years, financial protection has progressively reduced with 2 billion people in economic difficulty and 1.3 billion individuals pushed into poverty due to health costs. Data that tells not only of a health crisis, but of a profound social emergency that crosses borders and continents, not sparing even the most developed countries such as Italy.
The situation in Italy: elderly people and giving up care
In our country, despite a universal healthcare system, the situation is not free from critical issues. According to the Passi d’Argento surveillance data, published by the ISS, the Higher Institute of Health, in the two-year period 2022-2023, 18% of over 65s, around 2.6 million people, has waived at least one medical visit or diagnostic test that he would need. Long waiting lists, excessive costs of services, logistical difficulties are among the main causes of this waiver.
December 12 is Universal Health Coverage Day (Getty Images)
In the South, more disparity
The the problem is exacerbated in the southern regions, where the highest dropout rates are recorded27%, compared to 16% in the North. The economic disadvantage and low level of education have the greatest impact on the possibility of accessing treatment.
The Istisan report Breast and colorectal cancersdeveloped by the ISS, highlights how in the southern regions the mortality rates, historically lower in the South, are now comparable to those in the North. Among the causes of this disparity, the reduced use of oncological screening plays a crucial role: in the southern areas, where participation in screening is lower, mortality is higher.
The “escape” to the north for treatment
Another sad phenomenon that affects the South is also that of healthcare mobility: in the South, the number of patients forced to travel to receive treatment is triple compared to the Centre-North. Calabria and Molise lead this sad rankingcombining low levels of screening with the highest indices of health “escape”.
A two-speed system
The reality that emerges is that of a two-speed healthcare system, where the economic disadvantage also turns into a health disadvantage. Those with limited economic resources not only give up treatment more often, 39% of those with economic difficulties, but when he manages to access it he often has to go private: 59% of respondents had to do this at least once.
Looking to the future
The goal of universal health coverage, set by the UN for 2030, seems to be moving away rather than closer. The fundamental question, however, it’s that it’s not just about numbers and statistics, but of human lives. Every waiver of a medical visit, every missed screening, every forced trip to receive treatment, in fact, represents a failure of the system and a step backwards on the path towards truly universal healthcare. The challenge for the future is to ensure that no one anymore has to choose between treatment or eating.
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