Ticino focuses on the politics of health
The government in the Italian-speaking canton of Ticino is taking a new and innovative approach to tackle spiralling health care costs.
The cantonal authorities have begun a systematic analysis of the impact political decisions have on the health of the population, which they believe will help avoid additional costs.
The aim of the Health Impact Study (HIS) is to evaluate the effects of a specific measure on public health.
"Ticino is taking a pioneering role in the field of public health," said Ticino’s health minister, Patrizia Pesenti.
The HIS will enable the authorities to optimise resources invested in health care in order to keep costs in check.
Ticino is the first canton to introduce such a system, but other cantons (Geneva, Jura, Fribourg, Valais) have expressed an interest in following suit.
Ticino has launched an initial evaluation project under HIS.
"The aim [of the project] is to evaluate the impact on people’s health of a plan in the Mendrisiotto region to build more roads," said Pesenti. This area bordering northern Italy is seriously affected by pollution.
Previously, the authorities would only have requested a study of the effects such a plan would have on the environment.
Also earmarked for evaluation is a plan to reintroduce a dental service in schools, the situation of unemployed people over 50 years of age, single-parent families and foreigners experiencing difficulties integrating into society.
The World Health Organization supports this approach and is promoting international collaboration. In September 2002 the European Union also decided to promote the HIS process.
"This experiment will last until the end of the legislative period," Pesenti said. "Then it will be possible to make an initial assessment."
According to Pesenti, the Netherlands is the only country which has adopted a similar procedure at the national level.
Improve living conditions
“The central issue that governments must address is improving living conditions to enable people to maintain a good level of health,” she said.
“Every year we spend around SFr50 billion ($42 billion) in Switzerland to improve a healthcare system which is already endangered, while nothing is being done to help the population maintain their own health capital,” she added.
The HIS commission selects key projects in terms of their potential impact on public health and informs the cantonal government about them.
Based on the information reported about these measures, the government decides which projects should be included in the HIS procedure.
It decides if and under which conditions a specific project should be initiated or how it should be implemented.
A national working group has been set up to monitor the Ticino experiment.
swissinfo, Françoise Gehring in Bellinzona
The Swiss healthcare system accounts for over 11% of GDP.
Ticino is the only canton with an action plan to evaluate the impact of political decisions on public health.
The cantons of Fribourg, Jura and Valais are also addressing the issue of health impact studies through draft laws, decrees and ordinances.
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