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RPS 4 2017

Dopo l’ondata migratoria del secondo dopoguerra, l’emigrazione italiana si è attenuata ma mai esaurita e negli ultimi anni ha conosciuto una ripresa delle partenze sempre più consistente.

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health and care system

Mimmo Lucà

Articolo scritto da:

As President of the Parliamentary Commission on Social Affairs I’d like to offer a few brief thoughts on the subjects introduced here and on which there has been a discussion, offering an institutional point of view on the path to follow. I refer in particular to the law on non-self-sufficiency, which is being discussed by the Commission I chair, and which comes from a failure in the previous Parliament. The Hon. Zanotti dealt with it in the last Parliament, and this time too, there is a risk of it finishing on the rocks of financial covering. This law is based on the setting up of the Fund for non-self-sufficiency, and it is clear that if this fund is not adequately financed with the necessary resources to guarantee an essential level of services, then the law cannot be approved.only subscribers can see the full article

Labour Market and Professionalization of the Care and Health System in Italy

Articolo scritto da:

This article presents and discusses some characteristic features of welfare work in Italy, to try and understand better some of the challenges that the welfare system is facing today and, still more, will be facing in the near future. To deal with this subject synthetically, I propose to start from two central elements in the development of the Italian labour market in this field. The first, in the social field, is that of the unofficial «carers», that is, the private care work provided mainly by immigrant women to old people who are not self-sufficient and to the disabled. The second, in the health field, is that of the acceleration of the professionalisation process in the last ten years. These two phenomena will involve discussion of the labour market, regulation of the professions and professionalism. only subscribers can see the full article

Care for the Non-Self-Sufficient in the Context of the New Unfinished Regionalism

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Traditionally the creation of a welfare state has tended to centralise the powers and functions of central government in contemporary legal systems, as central government is regarded as offering better guarantees of stability and universal social services than more local bodies. This «centripetal» tendency of the policies connected with the creation of the welfare state has been noticed by constitutionalists since the 1980’s, particularly as regards federal systems, where egalitarian policies aimed at redistributing wealth have often set off processes centralising powers and functions in federal authorities, because of the need to guarantee uniform welfare standards nation-wide, in the interests of substantive equality. only subscribers can see the full article

Rare Diseases as an Example of Contrasting Marginality

Articolo scritto da:

in the issue
Nhs
Rare diseases are an heterogeneous set of human pathologies whose common features are the low frequency rate in the population (under 5:10,000, according to European criteria) and serious social and health problems associated with such a low frequency. Their number involves a consistent part of the population (approx. 6,000). These pathologies are little known and studied, often chronic and crippling, for which social and health interventions must include support for life and work choices to persons affected. Important public health initiatives are underway at both the national and international levels.only subscribers can see the full article

The Regional Law of Friuli Venezia-Giulia. The Fund for Possibile Autonomy

Articolo scritto da:

My aim in these notes is to bring my own experience in the field to the debate: after battling for twenty years as a psychiatrist to dismantle the mental hospitals, and then ten more years to build alternatives to them, I have spent the last ten years managing local health units: three years in the province of Caserta and now in the Region of Friuli Venezia Giulia. I’d like to offer you some reflections from this viewpoint, on the basis of the kind of problems I meet every day in my work. In the regional law of Friuli Venezia Giulia, the non-self-sufficiency fund is known as a «Fund for possible autonomy». Just a matter of terminology? Perhaps. only subscribers can see the full article

The Costs of the Failure to Integrate Social and Health Care

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That health service costs tend to increase staggeringly is well known. The most recent forecast of PricewaterhouseCoopers Health Research Institute estimates a tripling of its impact on Gdp in the next fifteen years, reaching 21% in the USA and an average of 16% in other OECD countries. Italy’s relatively favourable position at 8.5% will tend to be eroded, if for no other reason than the worldwide tendency of health service consumption, supply systems and costs to converge. only subscribers can see the full article

Achille Passoni

Articolo scritto da:

I want first of all to dwell on some questions that were dealt with today by the Minister for Social Policy, Paolo Ferrero, which, quite honestly, I find difficult to share. First of all, the question of the Social Policy Fund. The resources to transfer to the Regions in 2007, compared with those transferred in 2006, have indeed increased — and we much appreciate this — but only to an extent equal to the cuts made by the previous government last year. That means that the Fund now stands at the same figure as in 2004. Substantially, there has been no additional investment since then down to the end of 2007. And this means that social policies and combating poverty are not seen as a priority by the new Centre-Left government. The Minister will agree with me that this is not at all good news. only subscribers can see the full article

Economic Evaluation in Care and Health Services

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Population ageing and technological development in industrialised countries have helped bring to the fore the subject of the efficient allocation of resources in welfare systems. In the health sector, economic evaluation is a tool designed to guide allocation decisions in relation to a crucial dimension of the problem: the opportunity cost. Since the 1960’s a strong increase in the number of studies has been noted particularly in the pharmacological sector, and in many countries the results of these studies have been used to issue specific guidelines. only subscribers can see the full article

Data, or Ambivalence

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Both common sense and methodological reasons should make it obvious that every time we leave a strict «experimental» context, data have extremely and explicitly ambivalent relations with the reality they describe, plan and evaluate: this is part of their role, which is never independent of context, and still less neutral or objective. The data are in the service of a hypothesis (in the best of cases: that means they correspond to an explorative work of research or comparison), or a theory (more frequently: they are a response to a plan that seeks to demonstrate, defend or confirm something that has already been decided). In systems that are more or less rapidly being redefined or evolving, and that are already «dependent» on «other» macro-variables, the potentiality/possibility of profound ambivalence in the data translates almost naturally into concrete and/or planned probability.only subscribers can see the full article

«Cura»

Articolo scritto da:

in the issue
Nhs
In the Italian language one term «cura» is used to express both the complex therapeutic equipment and procedures used to fight the disease (to cure), as well as the wider and more general attention and concern towards the suffering and fragility of others (to take care of). This polysemy conceals the parallel course of which the two dimensions of care have been the protagonists since the origin of scientific medicine, and which is now making a comeback given the emergence of some phenomena culminating in the incurability of the patient. Yet, to avoid the risk of a sterile reductionism or a mere juxtaposition, it is necessary to go back to the most ancient roots of such an antithesis, going back over the history of medicine from its mythological origins to the beginning of clinical medicine.only subscribers can see the full article