Il riparto del FSN-2011: Il gico è valso la candela? (F. Pammolli e Nicola C. Salerno, CeRM Roma)

by Nicola Carmine Salerno

Le previsioni fatte da CeRM nei giorni scorsi sembrano esser state lungimiranti. Ieri (20 Aprile 2011) stati suddivisi tra le Regioni 104,867 miliardi di Euro come risorse non vincolate, oltre a 1,6 miliardi di Euro come risorse vincolate agli obiettivi di Piano Sanitario 2011.

Nell’ultima Tavola in allegato si descrive il confronto tra le quote (%) concordate per il riparto delle risorse complessive (non vincolate e vincolate), e le quote che sarebbero emerse se si fossero utilizzati, come pesi per il riparto, i rapporti di fabbisogno pro-capite per fascia di età rilevabili nelle Regioni benchmark.

Le differenze tra le quote spettanti alle varie Regioni (19 Regioni più 2 Province Autonome) appaiono molto contenute. Addirittura, dieci differenze restano nell’ordine di centesimi di punto percentuale, con tre Regioni (Sardegna, Valle d’Aosta, Veneto) che di fatto non vedono nessun cambiamento nelle loro quote di riparto. La differenza massima è quella della Campania, con un miglioramento di 0,76 p.p., seguita dalla Toscana, con un peggioramento di 0,34 p.p.. I rimanenti nove scarti sono, in valore assoluto, al di sotto dei tre decimi di punto percentuale.

La domanda è quella già proposta nei giorni scorsi: “Il gioco è valso la candela?”. Mesi di interazione tra Regioni, faticosa, costosa, per molti versi anche non perfettamente trasparente, sostituibili con una regola di riparto codificata ex-ante, chiara e che, oltre alla proprietà di efficienza che le deriva dal benchmarking, mette in atto una strutturale perequazione tra territori.

Questa regola potrebbe essere adottata subito e mantenuta nel medio periodo (con manutenzione ordinaria ogni 5-7 anni); e gli sforzi di Stato e Regioni concentrati sulla perequazione infrastrutturale, sul riassorbimento dei gap di efficienza di gestione corrente, e sul rientro dalle posizioni debitorie esistenti nei Ssr.

21 Aprile 2011

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