ROMA (ITALPRESS) – A national public health service cannot work with different criteria depending on who delivers a performance or accesses resources. Same performance must mean equivalent guarantees; tariffs must result from verifiable costs; public investment must meet transparent and knowledgeable criteria. It is the message with which UAP – National Union Ambulators, Poliambulatori, Enti e Ospedale Privata – returns on the themes emerged from the national conference of 9 September in Piazza Montecitorio, moderated by Maria Grazia Cucinotta.
“The point is not to defend one category against another – says President UAP Mariastella Giorlandino –. The National Health Service is one and its direction must remain public. But for this reason the public must ensure consistency in the rules, program all the skills available and make transparent the criteria with which the resources are used.”.
The UAP analysis of the tariff proposal 2026 shows a very clear figure: 78% of tariffs remain unchanged compared to November 2024. An additional 8% is increased, but less than the inflation matured in the same period. Ultimately, 86% of the tariffs for 2026 did not recover the inflation from November 2024. Only 14% recorded an increase higher than inflation. For UAP, this fact makes it difficult to argue generically that the problem has been solved because “the rates have increased”.
Comparison with inflation does not, however, determine whether tariffs are adequate to the actual cost of performance. And that is precisely the point: it is necessary to make transparent and verifiable as from the cost of the single performance you have reached the rate recognized by the SSN. This comparison does not show on its own whether a tariff is adequate to the cost of the benefit. It shows however how much it is necessary to make verifiable the path that leads from the cost actually detected to the tariff recognized by the SSN. Emblematic the case recalled by FederCardio during the conference: €5.85 for a cardiological visit of control including electrocardiogram.
“We do not ask for indiscriminate increases – says Giorlandino –. We ask you to know how much it costs efficiently to provide a performance and how from that cost you get to the rate.”.
The second issue concerns the extension of individuals who can offer health services and services. UAP does not challenge the role of pharmacies or the possibility that they contribute to making certain services more accessible to citizens. However, there is a question of principle: when different subjects provide equivalent health services, equivalent guarantees must be ensured.
Authorization, quality, safety, professional responsibility, equipment requirements, process traceability and proper integration with health information systems cannot depend on the nature of the dispenser. “We do not ask less services in pharmacies – says Giorlandino –. We demand the same guarantees for the citizen for the same performance.”.
It is this, for UAP, the way to really expand the offer without creating a double lane health. A third issue concerns transparency in the use of public resources. The decree of the Minister of Economy and Finance of 7 August 2026 has allocated 60 million euros to the Fondazione Policlinico Universitario Agostino Gemelli IRCCS for eight investments. UAP does not question the value of the Gemelli, one of the excellences of Italian health, nor the usefulness of investing in the structures that perform strategic functions for the SSN.
The question concerns the method. State resources fully cover the cost indicated for the eight interventions. It becomes therefore important to know the criteria through which priority projects have been identified and how other excellences, public and private accredited, can access similar opportunities.
“A strong public direction must be able to invest where it believes it serves – notes Giorlandino –. But it must also make the identified needs understandable, priorities, selection criteria and expected results.” The question of resources adds that of professionals.
The difficulty of keeping qualified doctors no longer concerns only public structures, but also accredited private ones. Insufficient rates and rigid budgets can facilitate the transfer of professionals to the pure private, subtracting capacity to the network that delivers performance on behalf of the SSN.
The result directly concerns citizens: less professionals in the public and accredited mean less welfare capacity and greater pressure on waiting lists. UAP proposes to overcome the logic of extraordinary tariff revisions through a stable system: analytical determination of the efficient cost of the single performance, verifiable tariff-base, periodic indexing, structural revision when changing technologies, organization and care processes.
Indexation would prevent a properly determined rate from progressively losing value; analytical revision would allow instead to remake the accounts when it really changes the way of providing care. Also in diagnostics, according to UAP, programming cannot depend exclusively on volumes. Proximity, quality, safety, appropriateness and ability to respond to the needs of the territory must comply with the evaluation, avoiding that purely quantitative criteria automatically penalize smaller structures.
“Our request is simple – concludes Giorlandino -. If a benefit is healthier, equivalent guarantees must apply. If public investment resources are used, the criteria for which they are assigned must be transparent. If certain national rates are determined, the ratio between the cost of the benefit and the rate must be verifiable. We do not ask for privileges for someone and do not want to oppose public, private accredited, pharmacies or large structures. We call for stronger public direction, consistent rules and health-oriented resources. Because the National Health Service is one. And one must be the right to cure.”.
-Photo IPA Agency-
(ITALPRESS).
