[Correspondence] The Italian health-care crisis—only a matter of funding?

Having noted that Arianna Magon and Rosario Caruso erroneously refer to the Italian National Health System (INHS) in the title of their Correspondence,1 we would like to note that in Italy we also have a public National Health Service (NHS) mostly funded by taxpayers,2 which was initiated in 1978 in the wake of the English NHS and should provide universal coverage. A widespread weakness of the INHS throughout the country that is not underlined in the Correspondence is primary care. Although g...

[Correspondence] Europe has much to do to improve the quality of and access to safe pain management

We have read with interest the debate surrounding opioid use in the USA and related deaths. We also welcomed the different perspectives of Gerard A Kalkman and colleagues,1 concluding that universal health care and addiction care in Europe contributes greatly to preventing an opioid epidemic of US proportions. If we agree with many points, we respectfully disagree that this prevention is homogeneously helping to prevent such a crisis development. The authors mentioned only the opioid crisis i...

[Correspondence] The effect of Medicare for All on rural hospitals

Alison Galvani and colleagues1 robustly modelled the effect of the Medicare for All Act on US national health expenditures and outcomes. Spending on hospital care and physician or clinical services accounts for 53% of total spending. Their model assumes that Medicare rates are uniformly 22% lower than are private-payer rates and that, by switching all fees to Medicare rates, overall reimbursements will be 6% lower for hospitals and 7% lower for physicians.

[Correspondence] The Global Kidney Exchange programme – Authors’ reply

Marta López-Fraga and Beatriz Domínguez-Gil make their point about our Health Policy on the ethics of the Global Kidney Exchange (GKE) programme1 by asking us to imagine that Alyson, an Ohio farmer, is willing to donate a kidney to her daughter but unable to afford the surgery. Medicare pays for kidney transplantation surgery in the USA, even for people younger than 65 years, so there is no way in which GKE could prevent Alyson's daughter from receiving a kidney from her mother. Kidney transp...