by InTrieste
In a striking address at the 2024 Meeting in Rimini, Massimiliano Fedriga, governor of Friuli Venezia Giulia and president of Italy’s Conference of Regions, emphasized the urgent need for systemic reform in both welfare and healthcare. Speaking during a panel titled “Living Longer, Living Better? Welfare at a Crossroads,” Fedriga outlined his vision for the future of public services in Italy, focusing on the need for greater autonomy and responsibility at the local level.
The governor’s remarks come at a time of significant debate in Italy about how to handle the country’s evolving welfare needs, particularly in light of an aging population and declining birth rates. According to Fedriga, a shift towards “differentiated autonomy” for regional territories could pave the way for more effective social services, allowing local governments to address their unique challenges without relying solely on national intervention.
“The future of welfare and healthcare depends largely on the responsible choices made by local territories,” Fedriga stated. He argued that granting local governments more control over how services are administered could reduce inefficiencies and improve outcomes for citizens. “If we don’t give responsibility to the territories, it’s always someone else’s fault—whether that be the State, Region, or Municipality,” Fedriga noted.
Fedriga dismissed concerns that this approach would exacerbate inequality between wealthier and poorer regions, explaining that funding mechanisms would be structured based on the cost of services provided rather than local revenue disparities. “There should be no concern in this regard,” he assured the audience, emphasizing that this reform should be seen as a collective effort to improve public services.
Joining Fedriga on the panel were Lucia Albano, Undersecretary of the Ministry of Economy and Finance; Stefano Bonaccini, Member of the European Parliament; and Pierciro Galeone, Director of the Institute for Local Finance and Economy (IFEL). The discussion was organized by the Foundation for Subsidiarity, an institution devoted to promoting social and economic inclusiveness.
A Call for Pension Reform
Fedriga also addressed the imbalance between resources allocated to pensions and those dedicated to social assistance, an issue that has long plagued Italy’s welfare system. “It is now necessary to implement a comprehensive reform,” he declared. “We must separate pensions from social assistance. Currently, pension benefits are too disparate in nature; we need to differentiate them and classify all socio-assistance-related pension supplements under welfare.”
This proposal signals a push for deeper reforms in Italy’s public spending model, a topic that has generated widespread discussion as Italy grapples with its ballooning welfare expenditures.
Redefining Healthcare in the Face of Social Change
On healthcare, Fedriga delivered a stark message about the future challenges facing Italy’s system, particularly in relation to demographic shifts. As Italy’s population ages and birth rates continue to decline, he warned that the country must reevaluate its healthcare model. “Given the significant social changes, particularly due to the declining birth rate and the aging population, it is necessary and urgent to change the healthcare model,” Fedriga said.
The governor called for expanded use of technology, including telemedicine, to address personnel shortages, particularly in the nursing sector, which he warned will continue to worsen in the coming years. Telemedicine, he argued, could be crucial in filling the gaps left by a diminishing workforce.
Fedriga was also blunt about the shortage of doctors. However, he pushed back against calls to eliminate Italy’s restrictive admissions policies for medical schools, known as numero chiuso (closed number), which cap the number of students allowed to study medicine each year. “Talking about eliminating the cap on medical school admissions is profoundly wrong,” he asserted. Citing data, Fedriga suggested that by 2027, Italy would have more medical graduates than retiring doctors, a mismatch that could create other problems for the healthcare system. “We will face a dramatic shortage of nurses,” he cautioned, warning that increasing medical school slots could divert potential nursing students, deepening the crisis.
A Shared Effort
Throughout his speech, Fedriga underscored the need for collective action, stressing that these reforms are essential to ensure better public services for Italian citizens. The governor’s calls for autonomy, reform, and technological adaptation signal a significant push towards reshaping Italy’s welfare and healthcare systems as the country faces profound social and economic challenges in the years ahead.
