|Patients jammed into an Italian emergency room corridor|
Americans who knew something about Italy used to nod knowingly when I’d tell them the National Health Service was going from bad to worse, saying: “Ah, that bastard Berlusconi.” Not so. Silvio Berlusconi, small-minded as he may have been as on-again-off-again Premier between 1994 and 2011, did relatively little harm to the health care system; his political program never went far beyond (1) keeping himself out of jail and (2) getting to paw lots of women, the younger the better. By the time Angela Merkel and the European Bank maneuvered the Italians into giving Berlusconi the boot, he had made only a few timid cuts in public medicine. It was Merkel’s more respectable buddy Mario Monti, the sober economics professor she and the other Europeans installed to take over from Berlusconi as Prime Minister, who proceeded to force austerity with a vengeance on Italian regions in deficit, which meant most of them. Poof! there went the hospital beds, and the staffing, leaving patients amassed on gurneys in emergency room halls. Mario did more damage to ordinary Italians’ health care in one year than Silvio had in seventeen.
Seven years down the line, there’s been another game-changing shift in Italian politics, including medical politics. This time, though, the protagonists are dangling pledges to spruce up the National Health Service rather than vowing to undermine it. The right-wing League and the no-wing Five-Star Movement, the two parties currently – and improbably – sharing power, have made rosy joint promises to restore funding for the public medical sector, fight corruption, and improve services. Plus promising their constituents everything from earlier retirement to a guaranteed minimum income.
But it’s all pie in the sky, based on a magic trick. At the same time as the Five-Star people campaigned on beefing up the welfare state, their buddies in the League were swearing to slash taxes for businesses. When they cobbled together a government, each party stuck to its own promises, despite the glaring contradiction between taking in less and spending more. European Union economic authorities did some arithmetic and turned thumbs down. The Italians have so far dug in their heels. Who will blink? Will the National Health Service ever receive that badly-needed infusion of cash? At this point it’s anyone’s guess, but I wouldn’t hold my breath.
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