Italy's current affairs

The Italian health system: sustainability, quality and responsibility

Demographic waves, technological innovation and citizens' expectations: these are today's major
challenges. And, in the years to come, healthcare will become an increasingly important issue in
all major countries with advanced economies and welfare systems. In the Italian system, the
healthcare challenge is particularly crucial as it represents the largest public expenditure after
pensions. The knot that needs to be loosened is that of the sustainability of the Italian welfare
system. In justifying the elevated costs - which cannot be avoided as they are tied to the universal
nature of healthcare in the European social state model - access to services and the quality of
services delivered must be guaranteed. Reforming the Italian healthcare system also means
intervening in the complex measures that allow the system to assimilate scientific and
technological innovation and diagnostic/therapeutic progress. Such progress opens the way for
new sorts of hospitals, which can delegate diagnostic practices to generalist facilities spread
throughout the territory and therapeutic practices to more highly specialized facilities.

Fiscal federalism: the measures needed for modernization and efficiency in Italy
The participants at this conference observed that fiscal federalism in Italy represents an
opportunity not to be missed if the country is to embark on a new and more modern approach to
public administration and policies which brings citizens into closer contact with the authorities
responsible for making revenue and expenditure decisions. The recovery of efficiency margins
must constitute a priority goal of fiscal federalism, which should aim to eliminate any form of
duplication in the performance of functions. Rather, there should be an emphasis on freeing up
resources that could be progressively ploughed back into the private sector by reducing tax
burdens. For the purposes of ensuring the complete success of the reform, it must represent the
outcome of a wide debate, to be conducted within a parliamentary forum, involving
representatives from sub-national levels of government and from both sides of the political fence.
This process should start with a survey of revenue and expenditure flows at the central and sub-
national levels, which all relevant responsible institutions should assist with. Finally, of pivotal
importance (in terms of measures aimed at ensuring effective political management of the
transition process leading up to the definitive introduction of fiscal federalism) was the
suggestion that Italy should pass from a system of co-equal bicameralism, as envisaged by the
Constitution, to an unequal bicameralism model, thereby guaranteeing adequate representation
for local autonomies.

Global economies and Italian businesses: high technology, creativity and design as the keys
to success
The conference discussion focused on the fact that the global economic scene is suffering from a
worldwide slowdown in growth, the effects of the recent American financial crisis, monetary
imbalances between the US dollar and the euro and rising inflation due to an increase across the
board in the price of raw materials (and not just energy resources). The growing complexity of
global economic, financial and monetary scenarios has compelled Italian business and the Italian
economic system to adopt a different approach to increasing competitiveness and growth. The
sectoral specialization model is still based on so-called "cash-cow" products, but businesses have
innovated in their processes, products, organization and markets. The quality-price mix has
changed, with a renewed emphasis on brands, reliability, design and the combination of form and
functionality. Several adaptable multinationals have also established themselves as leaders in
global niche markets. Even this is an innovation, underlining the strength of the "fourth
capitalism" made up of Italian businesses that have 500 million to 3 billion euro in turnover.
Nevertheless, it was felt that there is no call yet for over-optimism, given that the international
competition is hard on Italy's heels.

Organizational models and new incentives for research in Italy

The future and competitiveness of Italy depend on research development and on the productivity
of the university sphere. The conference debate centered on the rules and mechanisms required
to innovate and strengthen Italy's research sector, exploring, in particular, ways of financing
research and mechanisms for ensuring transparency and meritocracy. Another hotly-debated
issue was the need to make the most of human capital and to rejuvenate the research sector,
moving from a brain drain to a brain gain, by overcoming the overabundance of administrative
and legal hurdles and attracting qualified human capital from abroad into universities and
research centers. Thus, greater investment is needed. However, more importantly, new rules and
organizational models are required that guarantee a leadership role in Europe for Italy in areas in
which the country has already demonstrated excellence, and that also enable Italy to face the
challenges posed by the United States, China and India. Discussion focused on the link between
research, the national interest and local area development, analyzing the mechanisms required in
order to bring about territorial groupings capable of generating research and innovation.

Politics and anti-politics

The conference highlighted several historical problems which afflict the relationship between
Italians and their political leaders. Italians widely view their politicians as lacking moral
rectitude, costing too much and being inefficient. The unpopularity of the political sphere today
can be principally explained by the fact that it is perceived as using up public resources and not
providing a service to citizens. In order to renew Italy's political class, the current perverse
method of selection based on party loyalty and devotion to a political leader must first be
abolished. Selection must then be based on merit, skills and professional experience. A shared
culture of rules that need to be followed also needs to be instilled. Only in this way will it be
possible to once again revive constructive dialogue on important issues that truly reflects the
diversity of approaches to society and development. The analysis conducted during the
conference was further enriched by a comparison between various international models, with
mention being made of Angela Merkel in Germany, the US primaries and political model as well
as the phenomenal success of Sarkozy in France.

Moving from "Made in Italy" to "Made best in Italy"

The conference participants noted that the Made in  Italy label represents a tradition of
excellence which needs to be relaunched on the international market as soon as possible by
breathing new life into support mechanisms for Italian export companies. Closer attention also
needs to be paid to the important debate currently in progress regarding international trade rules
and strategies to protect and promote production. Europe, in turn, was called on to revisit its
trade policy from a new perspective, to adopt a more aggressive and more effective approach.
The participants highlighted that, although businesses operating in the field of the so-called three
"Fs" (food, fashion and furniture) are particularly privileged in Italy, outside the country the
existence of other areas of excellence is recognized - areas which need to be acknowledged and
rewarded. Indeed, thanks to strong brand investment, a focus on strategic and budgetary targets
and attention to the traditional strengths of Italian production (namely creativity, design and
aesthetics), many companies have carved out a significant and recognized niche in the global
market. The conference participants also pointed to the importance of local area identity and the
role of finance in the growth of Italian companies.

Convergence Italian style: how is the telecommunications market changing?

Innovation has been at the heart of all progress and industrial development in Italy. This was the
premise that underpinned the analyses and proposals - which emerged during the conference - for
a greater rationalization of the framework of European and Italian innovation mechanisms and
for further expansion of cooperation initiatives in this field. The participants also discussed Next
Generation Networks (NGNs) which, it was observed, are true information highways that are
platform-neutral and characterized by a high-information flow capacity, thus making services
possible that are independent of the type of network and technology in use. In order to take
advantage of the opportunity that NGNs provide to increase Italy's competitiveness, substantial
public and private investment is required and important political and legislative choices need to
be made. In particular, Italy will have to build new infrastructure and split existing networks. Old
and new operators alike, working in conditions of strong competition and within a clear legal
framework, will be called on to respond appropriately to market demand with content and
services that are highly interactive and conducive to the formulation of models for consumption,
social dynamics, entertainment and information-sharing, as well as business operational models.

Social integration, security and immigration: the challenges for Italy

One issue that is core to Italy's economic and political future is immigration. The local
administrators, political leaders belonging to various parties, leading religious and academic
figures, as well as representatives from the Italian trade-union movement and business sphere
who participated in the event underlined that immigration is fundamental for the development of
the country. The integration process must therefore involve the assimilation of different cultures
whilst respecting diversity. Several participants expressed a hope that the European model would
be followed, based on civic education and dialogue between diverse communities, without
overlooking the need to guarantee individual rights. The proposals put forward during the
discussion included: assisted voluntary repatriation, greater Europe-wide cooperation between
police forces and efforts to overcome mistrust between countries in order to pool together their
individual database resources.