Cross-border healthcare workers: Como is gasping for air

Context

TL;DR

• Around 5'000 Italian cross-border workers in Ticino's healthcare sector
• Up to 12% in public hospitals
• Up to 30% in the private sector
• Health tax from 3% to 6% of net salary

Key facts

• People: about 5,000 Italian border workers
• Scope: Ticino health
• Peak in public hospitals: up to 12% of staff
• Peak in the private sector: up to 30% of staff
• Healthcare contribution: 3% to 6% of net salary

Approximately 5,000 Italian border workers work in the Ticino health sector. During peaks, their presence can reach 12% of public hospital staff and 30% of those in the private sector. The source indicates economic advantages as the dominant factor, but the cross-border appeal also depends on other reasons.

The service also gathers the motivations of two professionals. Federico Baldassarri, a nurse who has been working in a private facility in Lugano for a few months, explained that the main reason is the Swiss offer to a young graduate and the possibility of a considerably higher career development compared to the Italian context. Simona Franceschini, a colleague with a long career divided between the two countries, describes Switzerland as a leap in professional and human quality.

The health tax doesn't stop the recall

The imminent application of the so-called health tax provides for a levy of between 3% and 6% of the net salary. The cost will be borne by border workers who were already working in Switzerland before July 2023, while the revenue will finance the Italian health service. According to the service, the measure does not seem to attenuate the cross-border appeal to Ticino health.

The news therefore concerns two distinct plans but connected by the workers: on the one hand, the numerical presence in the staff of Ticino hospitals; on the other hand, the professional and economic reasons that drive Italian personnel to work in Switzerland. The source does not present the tax as a measure already sufficient to change this choice and does not indicate other amounts, deadlines or application methods in addition to the share on the net salary and the reference to workers already active before July 2023.

Operational details

The comparison between public and private

The first relationship discernible in the data is the difference between the two maximums: 30% minus 12% equals 18 percentage points. If 30 is divided by 12, the arithmetic ratio is 2,5. The calculation compares the maximum shares indicated for the private sector and public hospitals, but does not describe an annual average, an absolute number of workers per sector, or a trend over time. The source in fact uses the same framework of peak periods and does not provide any other intervals.

Why working in Switzerland is attractive

The second comparison concerns the reasons for the choice. The economic advantage is identified as dominant; the testimonies, however, add two qualitative elements. Federico Baldassarri speaks of the offer made to a young graduate and of career development superior to that in the Italian context. Simona Franceschini, who has worked for a long time in both countries, instead highlights professional and human qualities. The source therefore does not reduce staff mobility to a single item on the payslip: it describes a combination of economic benefit, career prospects, and the quality of the career path.

The text does not report salary amounts, pay differences, or the number of hires. For this reason, it does not allow us to calculate how much more a healthcare cross-border worker earns, nor to estimate what share of the choice depends on each reason. The only quantified economic datum is the healthcare contribution ranging from 3% to 6% of net salary for the group indicated by the source.

The relationship with this measure is described in observable terms: the cross-border appeal does not seem to be dampened by the imminent application of the health tax. However, no before-and-after measurement is provided, nor a count of the workers who would have changed their decision. The data therefore documents the persistence of Switzerland's appeal according to the source, without turning it into a prediction about the future behavior of cross-border workers.

Key points

The pressure on Como's hospitals

The difficulty concerns not only the ability of Ticino's healthcare system to attract personnel. According to the cited report, Como's hospitals are short of at least 500 staff members. The problem is presented as more widespread, because the shortage of medical personnel affects much of Northern Italy. The consequence indicated by the source directly affects patients: longer waits and greater difficulty accessing care.

Gianluigi Spata, president of the Como Medical Association, referred to the latest available data, concerning last year. In Italy, he stressed, 5,8 million patients gave up seeking treatment; the instances of foregoing care mentioned include examinations and follow-ups, associated with very long waiting lists. The figure concerns Italy and is not presented as specific to Como or Lombardy, so it cannot be equated with the shortage of 500 staff members in Como's hospitals.

The union's assessment

Angelo Goffredi, a CISL trade unionist, commented on the comparison with the Swiss labor market. His assessment is unequivocal:

Angelo Goffredi, a CISL trade unionist, described competition with the Swiss labor market as unequal, comparing it to the challenge between David and Goliath, and observed that current measures do not allow for competition.

The statement attributes a trade-union assessment to the competition; the source does not add an action plan, new staffing figures or a measure of the difference between the two markets. Instead, the two sides of the phenomenon remain documented: Ticino covers part of its staffing needs with Italian personnel, and Como's hospitals face a shortage of staff.

The scope of the article is narrower than that of a general guide for cross-border workers. The report discusses healthcare work and the health tax in Canton Ticino, but does not provide details on the G permit, AVS, LPP, LAMal, tax rebates, withholding tax or double taxation. These aspects therefore cannot be inferred from the reported data. To relate the indicated share to net salary, tax calculator is available.

Source: rsi.ch