On the communication of the National Health System to patients on the costs of health services

28 September 2012

Abstract

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In reply to a question raised by the Health Minister Prof. Renato Balduzzi, the ICB dealt with and debated the issue of the communication of average healthcare costs to patients by the National Health Service.
The text introduces the problem in the context of the complex question of the distribution of healthcare resources and analyses the different arguments which justify the direct communication to the patient (transparency by the state/region, making citizens responsible) and the argument against (possibility of making citizens feel guilty and introduction of an economic logic in healthcare).
The position of the NBC is based on these foundations.
Most of the NBC members considered the mandatory communication not ethically justified referring to the fundamental right to healthcare. Communication is allowed, as a possibility, if requested by the patient at the moment of being discharged from hospital or after receiving treatment.
Some members of the NBC declared themselves in favour of the mandatory communication, managed with due attention, as an instrument of transparency in a liberal and democratic society.
The ICB was unanimous on the modalities of the communication (for some possible, for others mandatory), with the recommendation that this be given in a specific document and not in the clinical record and in appropriate ways, avoiding making the patient feel guilty and discriminations and safeguarding the confidential nature of the personal details relative to health.
The Committee stresses that such communication must not be the only instrument to foster citizens’ awareness of healthcare costs, but must be included in the context of an overall education of society to take notice of the close connection between individual health and social health, stimulating awareness/knowledge and the assuming of responsibility on the part of the citizen with respect to the prevention of pathologies and risky behaviour and the curb on and proportionality of the demands made on the healthcare system.
Once again the Committee hopes that citizens/patients are guaranteed in the respect of the wish of whoever wants to know, the access to both general and more detailed information with regard to the costs sustained by the NHS for services received or to be given.

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