NationStates Jolt Archive


'Hospital of Horrors' in Milan rocks regional government

Risottia
12-06-2008, 13:08
'Hospital of horrors', many italian media titled in the last two days. To sum it up briefly, 13 doctors of a private clinic in Milan have been arrested by the police forces, after an year-long investigation started by an anonymous complaint. The allegations range from fraud against the State, production of false/forged documentations, needless surgery, most severe and permanent injuries, multiple murders with the circumstance of cruelty. This means that the arrested are facing the risk of permanent expulsion from the medical profession, and of being sentenced to ergastolo, that is jail for life.

Now investigations are widening their target, including many other private clinics, and the offices of the lombard regional executive, which is responsible for the healthcare system.

Google "milan hospital murder fraud" to find lots of links about it.

The lombard healthcare system is a mix of private and public: private clinics, who are certified by the regional executive as meeting some basical quality standards, have access to a public refund/subsidy system (called DRG), proportional to the numbers of patients treated, the severity of the disease and cost of the treatment.

This system was created by the centre-right majority led by Roberto Formigoni, ruling Lombardy since 1995. Formigoni, also the leader of the nationwide right-wing, ultracatholic political movement Comunione e Liberazione (now a group in PM Berlusconi's party), claims that the refund system combines the best sides of both public and private healthcare: that is, low-cost healthcare and high levels of efficiency granted by competition. Formigoni also claimed initially that he himself and his executive prompted the magistrates and the police forces to investigate; he was contradicted yesterday, though, during a session of the legislative assembly, by his current assessore (member of the Giunta, the regional executive) to healthcare, Bresciani, who admitted that the investigation had been neither requested nor prompted by the Giunta.

Formigoni often advertised the "lombard model" as representing "the excellency" of healthcare systems.

The criticism against this system, hailing both from the centre-left minority (which includes centre-orientered Partito Democratico, the Green Party (Verdi), Di Pietro's Italia dei Valori and communist parties PdCI and PRC) and from former members of the Giunta have always been strong - expecially because the healthcare system takes about 80% of the budget of Regione Lombardia. MD Alessandro Ce', formerly assessore (member of the Giunta) to healthcare, resigned from his position about one year ago and left the majority because of contrasts about further privatisation of the ambulance emergency service (known as the "118", the telephone number for medical emergencies). During yesterday's legislative session Ce', who retains his position as member of the Consiglio (the regional legislative) has had a bitter confrontation with Stefano Galli of Lega Nord, one of the parties of the centre-right majority. Galli accused Ce' of being "a traitor and a Judas" when Ce' reiterated his criticism of Formigoni's methods and systems.

Critics of the lombard healthcare system have often underlined the following arguments:
-lack of transparency about the certification of hospitals' standards (it is totally controlled by the Giunta)
-political affiliation criteria outweighing competence, when appointing the new directors of the public local health agencies (ASL) and of public hospitals - directors are appointed by the regional government
-links and conflict of interests between religious organisations (who own and run many private hospitals), Comunione e Liberazione, and other supporters and allies of Berlusconi's, like Don Verzè, a catholic priest and CEO of Milan's private hospital San Raffaele, which was involved in a lesser scandal some time ago right about unlawfully-obtained regional refunds
-difference of refunds between those given to private clinics and those given to public hospitals for the same treatments
-lack of continuous controls on clinics once they've been certified

Among others, former national Minister to Health and Healthcare in a centre-left cabinet, MP Rosy Bindi (PD), says that "the current investigatin proves that the lombard healthcare system is a failure".

The fact that a large part of the evidence has been obtained through phonetapping authorised by the prosecutors has stirred also additional criticism against Berlusconi's announcements of a new law forbidding all phonetappings, with the sole exception of investigations on terrorism and mafia. Under this prospected law, it would have been impossible to investigate some major scandals that have rocked Italy, like "Calciopoli" (the football scam of two years ago), insider trading and political meddling in the attempted acquisition of some banks, the unlawful phonetappings used by some telephone corporations, "Tangentopoli" - the unveiling of a widespread bribery system, which devastated the political panorama of Italy in the early '90s, or "Vallettopoli" - accusations are that Berluconi himself, during his 2001-2006 term as PM, used his political and personal influence over the State TV directors to obtain promotions for some starlets.


On a personal note, I hope that this will be a warning to any country who is considering to shift from pure public healthcare to public-subsided private healthcare.

(this commentary has been brought to you by Risottia, your man at Regione Lombardia! I would have posted it yesterday, but Jolt was being his usual jolty)
Vespertilia
12-06-2008, 13:26
<snip>

A couple of years ago we've been having quite a scandal: a group of ER paramedics were deliberately being too slow, or even administering killing drugs to patients - they were bribed by a funeral company to advertise them among families of the deceased patients, and to inform them about freshly deceased, and the guys were enterprising enough to capitalise on being paid for each call :)

should I add that this happened within public healthcare system?
Risottia
12-06-2008, 13:50
A couple of years ago we've been having quite a scandal: a group of ER paramedics were deliberately being too slow, or even administering killing drugs to patients - they were bribed by a funeral company to advertise them among families of the deceased patients, and to inform them about freshly deceased, and the guys were enterprising enough to capitalise on being paid for each call :)

should I add that this happened within public healthcare system?

The part I've bolded happens every day here.

Anyway Milan's scandals outlines that going private with public subsidy makes it only worse. The accused doctors came up even with implanting non sterile internal prosthetics, or scrap organic replacements for tendons, or to transplant lungs for pneumonia - just to get higher refunds.
The Romulan Republic
12-06-2008, 23:56
That is sick, and horrifying.

But damn, does this thread really need to turn into a debate on private vs public health care?
Risottia
13-06-2008, 00:11
That is sick, and horrifying.

But damn, does this thread really need to turn into a debate on private vs public health care?

Quoting my own OP,
"On a personal note, I hope that this will be a warning to any country who is considering to shift from pure public healthcare to public-subsided private healthcare."

It isn't "private vs public healthcare" (although I'm all for public and free healthcare) but "anything vs public-subsided private-run healthcare", that is, "anything vs the 'lombard model' ", which president Formigoni is so keen to advertise as the best healthcare system ever. So, next time some of your local politicians at the 'lombard model' as example... you've been warned!

It needs to become politics, since everything is politics, expecially healthcare system policies.
Call to power
13-06-2008, 01:02
horrifying though this leaves the question of how and if the system will be altered?

The fact that a large part of the evidence has been obtained through phonetapping authorised by the prosecutors has stirred also additional criticism against Berlusconi's announcements of a new law forbidding all phonetappings, with the sole exception of investigations on terrorism and mafia. Under this prospected law, it would have been impossible to investigate some major scandals that have rocked Italy, like "Calciopoli" (the football scam of two years ago), insider trading and political meddling in the attempted acquisition of some banks, the unlawful phonetappings used by some telephone corporations, "Tangentopoli" - the unveiling of a widespread bribery system, which devastated the political panorama of Italy in the early '90s, or "Vallettopoli" - accusations are that Berluconi himself, during his 2001-2006 term as PM, used his political and personal influence over the State TV directors to obtain promotions for some starlets.

hmmm I mean its good and has worked wonders...dammit why am I the only one who goes through OP's with a fine toothed comb!
Risottia
13-06-2008, 10:38
horrifying though this leaves the question of how and if the system will be altered?

Options currently being debated are:
1.eliminating any refund system for private healthcare (very unlikely)
2.continuous controls on hospitals and more transparency (easy)
3.giving the regional legislative more powers about healthcare, both about appointment of local directors and about controls


hmmm I mean its good and has worked wonders
Sarcasm? Really, explain - I can't get your point here.