17 febbraio 2018
News
L’allarme lanciato dalla Fnomceo: «Tra 10 anni, 14 milioni di persone potrebbero trovarsi senza medico di base»
Il conto è presto fatto: se tra dieci anni trentatremila medici di famiglia andranno in pensione, e solo undicimila new entry arriveranno a sostituirli, ci saranno ventiduemila medici di famiglia in meno. E, a farne le spese, saranno 14 milioni di persone, che si troveranno senza medico di base oppure con un’assistenza sanitaria insufficiente.
Non va meglio per i medici del Servizio sanitario nazionale: nei prossimi dieci anni ne verranno a mancare per pensionamento 47.284.
«La Fnomceo ha lanciato già da tempo l’allarme: se non si correrà ai ripari, e subito, tra dieci anni mancheranno medici di famiglia e specialisti», afferma Filippo Anelli, presidente della Federazione nazionale degli ordini dei medici chirurghi e degli odontoiatri.
«Per contro, aumenterà il numero dei laureati sospesi nel “limbo formativo”, senza la possibilità di accesso ai corsi di formazione specifica in Medicina generale o di specializzazione, costretti ad aspettare che arrivi il loro turno per poter completare la formazione, rassegnandosi alla disoccupazione o sottoccupazione o fuggendo all’estero».
«Abbiamo molto apprezzato», prosegue Anelli «alcune prese di posizione della Politica che, in maniera veramente trasversale ai partiti (tutti, dall’on. Di Maio del Movimento Cinque Stelle a esponenti del Pd, di Forza Italia, allo stesso ministro Lorenzin hanno fatto sentire la propria voce), hanno proposto fattivamente e in modo mirato soluzioni possibili: in particolare, quella dell’onorevole Gelli che ha parlato di un “modello all’americana”, che conceda prestiti d’onore agli studenti, da restituire nei successivi vent’anni. Su questa via si sta muovendo anche l’Enpam, il nostro Ente previdenziale, che ha presentato il suo progetto a uno degli ultimi Consigli nazionali Fnomceo».
«Molti altri sono i possibili rimedi sia per alleggerire il limbo formativo sia per ampliare le fila dei Medici di medicina generale, dalla Laurea abilitante a un prolungamento temporale della graduatoria per l’accesso alla formazione, sino a un più efficace scorrimento delle graduatorie per la convenzione, oggi intasate e falsate da medici non interessati o ormai pensionati. Ma in questa situazione emergenziale, che è confermata da tutti i nostri dati, quelli di Fnomceo, di Enpam, delle associazioni sindacali, la prima, imprescindibile misura per mettere in sicurezza il nostro Servizio sanitario nazionale è quella di aumentare il numero di borse per le Scuole di specializzazione e dei contratti di formazione per il Corso di medicina generale».
«Chiediamo pertanto al ministro della Salute Beatrice Lorenzin, oltre alla più volte auspicata rivisitazione in aumento del numero di borse e di contratti», conclude Anelli «la riattivazione urgente del Tavolo tecnico sulle problematiche in materia di Medicina generale, già costituito nel luglio scorso ma rimasto sinora “dormiente”, e il suo ampliamento anche alle questioni relative alla programmazione delle attività formative specialistiche: la Fnomceo e la professione tutta non possono più restare soli ad affrontare questioni di tale impatto sociale».
(Ufficio stampa Fnomceo)
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Editore: Associazione Reportage - Direttore responsabile: Annamaria Persico
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n.initCustomEvent(e,t.bubbles,t.cancelable,t.detail),n}e.prototype=window.Event.prototype,window.CustomEvent=e}}(),function(e){e[e.Pending=0]="Pending",e[e.Loaded=1]="Loaded",e[e.Failed=2]="Failed"}(State$1||(State$1={}));class Provider{constructor(e){this.timeoutSeconds=5,this.handlePixelEvent=e=>{switch(this.state){case State$1.Failed:break;case State$1.Pending:setTimeout((()=>this.handlePixelEvent(e)),100);break;case State$1.Loaded:this.onPixelEvent(e)}},this.watch=()=>{switch(this.state){case State$1.Loaded:case State$1.Failed:break;case State$1.Pending:this.isLoaded()?this.state=State$1.Loaded:this.isTimedOut()?this.state=State$1.Failed:setTimeout(this.watch,50)}},this.config=e,this.identifier&&this.identifier.length>0?(this.state=State$1.Pending,this.timeoutAt=new Date,this.timeoutAt.setSeconds(this.timeoutAt.getSeconds()+this.timeoutAfter()),this.injectPixel()):this.state=State$1.Failed}get identifier(){var e;return null===(e=this.config)||void 0===e?void 0:e.key}get pixelEvents(){var e;return null===(e=this.config)||void 0===e?void 0:e.pixel_events}injectPixel(){this.injectedAt||(this.injectedAt=new Date,this.inject(),this.watch())}inject(){const e=document.createElement("script");e.text=this.script,document.head.appendChild(e)}isTimedOut(){return+new Date>=+this.timeoutAt}timeoutAfter(){return this.timeoutSeconds}selectPixelEvents(e){if(Array.isArray(this.pixelEvents))return this.pixelEvents.filter((t=>"term-view"===t.trigger&&"visit"===e||(!(!["term-click","ad-view"].includes(t.trigger)||"ctr"!==e)||"ad-click"===t.trigger&&"click"===e)))}}class Facebook extends Provider{get script(){return`!function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function(){n.callMethod?n.callMethod.apply(n,arguments):n.queue.push(arguments)};if(!f._fbq)f._fbq=n;n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0;t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','https://connect.facebook.net/en_US/fbevents.js');fbq('init', '${this.identifier}');`}onPixelEvent(e){this.selectPixelEvents(e).forEach((e=>{e&&(e.custom?window.fbq("trackCustom",e.event):window.fbq("track",e.event))}))}isLoaded(){return!!window.fbq}}class Outbrain extends Provider{get script(){return`!function(_window, _document) {var OB_ADV_ID = '${this.identifier}';if (_window.obApi) {var toArray = function(object) {return Object.prototype.toString.call(object) === '[object Array]' ? object : [object];};_window.obApi.marketerId = toArray(_window.obApi.marketerId).concat(toArray(OB_ADV_ID));return;}var api = _window.obApi = function() {api.dispatch ? api.dispatch.apply(api, arguments) : api.queue.push(arguments);};api.version = '1.1';api.loaded = true;api.marketerId = OB_ADV_ID;api.queue = [];var tag = _document.createElement('script');tag.async = true;tag.src = '//amplify.outbrain.com/cp/obtp.js';tag.type = 'text/javascript';var script = _document.getElementsByTagName('script')[0];script.parentNode.insertBefore(tag, script);}(window, document);`}onPixelEvent(e){this.selectPixelEvents(e).forEach((e=>{e&&window.obApi("track",e.event)}))}isLoaded(){return!!window.obApi}}class Revcontent extends Provider{get script(){return""}inject(){const e=document.createElement("script");e.src="https://assets.revcontent.com/master/rev.js",document.head.appendChild(e)}onPixelEvent(e){this.selectPixelEvents(e).forEach((e=>{e&&window.rev("event",e.event)}))}isLoaded(){return!!window.rev}}class Taboola extends Provider{get script(){return"window._tfa = window._tfa || [];!function (t, f, a, x) {if (!document.getElementById(x)) {t.async = 1;t.src = a;t.id=x;f.parentNode.insertBefore(t, f);}}(document.createElement('script'),document.getElementsByTagName('script')[0],'//cdn.taboola.com/libtrc/unip/1451879/tfa.js','tb_tfa_script');"}onPixelEvent(e){this.selectPixelEvents(e).forEach((e=>{e&&window._tfa.push({notify:"event",name:e.event,id:e.pixel_id})}))}isLoaded(){return Array.isArray(window._tfa)}}class Tiktok extends Provider{constructor(e,t){super(e),this.useAltTikTokEventsForAdsPlatformUser=t}get script(){return`!function (w, d, t) {w.TiktokAnalyticsObject=t;var ttq=w[t]=w[t]||[];ttq.methods=["page","track","identify","instances","debug","on","off","once","ready","alias","group","enableCookie","disableCookie"],ttq.setAndDefer=function(t,e){t[e]=function(){t.push([e].concat(Array.prototype.slice.call(arguments,0)))}};for(var i=0;i
{e&&window.ttq.instance(this.identifier).track(e.event)}))}isLoaded(){return!!window.ttq}}const ADS_PARAM$1="?caf",MESSAGE_PREFIX="FSXDC,.aCS:",ALLOWED_ORIGINS=["https://www.google.com","https://www.adsensecustomsearchads.com","https://syndicatedsearch.goog","https://googleadservices.com"];class Pixels{static build(e){const t=unpackPHPArrayObject(e,"pixel_tracking_data");if(t)return t.useAltTikTokEventsForAdsPlatformUser=e.is_ads,new Pixels(t)}constructor(e){this.onPixelEvent=e=>{const{detail:{type:t}}=e;switch(t){case"visit":case"ctr":case"click":this.providers.forEach((e=>e.handlePixelEvent(t)))}},this.providers=[new Facebook(e.facebook),new Tiktok(e.tiktok,e.useAltTikTokEventsForAdsPlatformUser),new Taboola(e.taboola),new Revcontent(e.revcontent),new Outbrain(e.outbrain)]}listenForEvents(){document.addEventListener("pixel",(e=>{this.onPixelEvent(e)}));window.onmessage=e=>{const{origin:t,data:n}=e;ALLOWED_ORIGINS.includes(t)&&(null==n?void 0:n.startsWith(MESSAGE_PREFIX))&&window.location.search.startsWith(ADS_PARAM$1)&&document.dispatchEvent(new CustomEvent("pixel",{detail:{type:"click"}}))}}dispatchEvent(e){document.dispatchEvent(new CustomEvent("pixel",{detail:e}))}}var State;!function(e){e[e.Pending=0]="Pending",e[e.Loaded=1]="Loaded",e[e.Failure=2]="Failure",e[e.TimedOut=3]="TimedOut",e[e.Errored=4]="Errored"}(State||(State={}));const CAF_SCRIPT_SRC=`https://www.google.com/adsense/domains/caf.js?${GOOGLE_MV3_URL_PARAMS}`,TIMEOUT_SCRIPTS=Number(GOOGLE_CAF_TIMEOUT_SCRIPTS),TIMEOUT_CALLBACKS=Number(GOOGLE_CAF_TIMEOUT_CALLBACKS);class StateMachine{constructor(){this.state=State.Pending}transitionTo(e){this.state=e}transitionFromPendingTo(e){this.done||(this.state=e)}get loaded(){return this.state===State.Loaded}get timedOut(){return this.state===State.TimedOut}get done(){return this.state!==State.Pending}}class Ads{constructor(e,t){this.state={script:new StateMachine,blocks:new StateMachine},this.blocksLoaded=[],this.injectScriptTags=()=>__awaiter(this,void 0,void 0,(function*(){return new Promise((e=>{const t=document.createElement("script");t.type="text/javascript",t.src=CAF_SCRIPT_SRC,t.addEventListener("load",(()=>e(!0))),t.addEventListener("error",(()=>e(!1))),document.body.appendChild(t),TIMEOUT_SCRIPTS>0&&setTimeout((()=>e(!1)),TIMEOUT_SCRIPTS)}))})),this.onPageLoaded=(e,t)=>{if(this.pageLoaded={requestAccepted:e,status:t},this.state.script.done)return;const n=null==t?void 0:t.error_code;n?(this.state.script.transitionTo(State.Failure),this.failureReason=`caf_pageloaderror_${n}`):this.state.script.transitionTo(State.Loaded)},this.onBlockLoaded=(e,t,n,i)=>{this.blocksLoaded.push({containerName:e,adsLoaded:t,isExperimentVariant:n,callbackOptions:i}),this.state.blocks.done||(t?this.state.blocks.transitionTo(State.Loaded):this.blocksLoaded.length>=this.blocks.length&&(this.state.blocks.transitionTo(State.Failure),this.failureReason=`caf_adloadfail_${e}`))},this.onTimeout=()=>{this.state.script.transitionFromPendingTo(State.TimedOut),this.state.blocks.transitionFromPendingTo(State.TimedOut)},this.blocks=e,this.options=t}get loaded(){return this.state.script.loaded&&!this.blocksLoaded.map((e=>e.adsLoaded)).includes(!1)}waitForBlocks(){return __awaiter(this,void 0,void 0,(function*(){return new Promise((e=>{const t=()=>{const n=performance.now();if(this.state.blocks.done)return this.cafLoadTime=Math.round(n-this.cafStartTime),void e();const i=this.blocksLoaded.map((e=>e.adsLoaded));i.includes(!1)||i.length>=this.blocks.length?e():setTimeout(t,50)};t()}))}))}inject(){return __awaiter(this,void 0,void 0,(function*(){try{const e=yield this.injectScriptTags();return this.cafStartTime=performance.now(),e&&void 0!==window.google?(new window.google.ads.domains.Caf(Object.assign(Object.assign({},this.options),{pageLoadedCallback:this.onPageLoaded,adLoadedCallback:this.onBlockLoaded}),...this.blocks),TIMEOUT_CALLBACKS>0&&setTimeout(this.onTimeout,TIMEOUT_CALLBACKS),yield new Promise((e=>{const t=()=>{this.state.script.done?e():setTimeout(t,10)};t()}))):void this.state.script.transitionTo(State.Failure)}catch(e){return void(this.error=e.toString())}}))}toCallbacks(){return{adLoadedCallback:this.blocksLoaded.slice(-1)[0],pageLoadedCallback:this.pageLoaded,cafTimedOut:this.state.script.timedOut||this.state.blocks.timedOut,cafLoadedMs:this.cafLoadTime,googleAdsFailure:!!this.failureReason}}toContext(){const e={cafScriptWasLoaded:this.state.script.loaded,cafScriptLoadTime:this.cafLoadTime,callbacks:this.toCallbacks};return this.error&&(e.js_error={message:this.error}),this.state.script.loaded||(e.zeroclick={reason:"googleAdsFailure"}),e}mockFailedState(){this.state.blocks.transitionTo(State.Failure),this.state.script.transitionTo(State.Failure)}}class TagManager{constructor(e){this.injected=!1,this.identifier=e}inject(){if(this.injected)return;if(!this.identifier)return;if("TEST"===this.identifier)return;const e=document.createElement("script");e.setAttribute("src",`https://www.googletagmanager.com/gtag/js?id=${this.identifier}`),document.head.appendChild(e),this.track(),this.injected=!0}track(){this.push("js",new Date),this.push("config",this.identifier)}push(e,t){window.dataLayer||(window.dataLayer=[]),window.dataLayer.push(arguments)}}const ADS_PARAM="caf",ADS_TRACKING_URL="_tr",BLOCKS_TYPE="ads",BLOCKS_CONTAINER="rs",KNOWN_CAF_PARAMS=["caf","query","afdToken","pcsa","nb","nm","nx","ny","is","clkt"];class Google{static build({pageOptions:e,preferredLanguage:t,blocks:n,googleAnalytics:i},s,a,o){let r={};e&&(r=Object.assign({},e),r.hl||(r.hl=t));let d=null==e?void 0:e.resultsPageBaseUrl;d||(d=window.location.origin);return new Google(s.uuid,n,r,i,d,o)}constructor(e,t,n,i,s,a){this._blocks=t,this._pageOptions=n,this.uuid=e,this._baseURL=new URL(s),this._signature=a,this.ads=new Ads(this.blocks,this.pageOptions),this.tagManager=new TagManager(i)}injectTagManager(){this.tagManager.inject()}injectAds(){return __awaiter(this,void 0,void 0,(function*(){yield this.ads.inject()}))}waitForBlocks(){return __awaiter(this,void 0,void 0,(function*(){return this.ads.waitForBlocks()}))}get blocks(){return(this._blocks||[]).filter((e=>this.wantsToServeAds?e.type===BLOCKS_TYPE:e.container===BLOCKS_CONTAINER)).map((e=>{const t=this.baseURL;new URLSearchParams(window.location.search).forEach(((e,n)=>{t.searchParams.has(n)||t.searchParams.append(n,e)}));const n=Object.assign({},e);if(n.resultsPageBaseUrl=t.toString(),this.wantsToServeAds){const e=new URLSearchParams;e.append("click","true"),e.append("session",this.uuid);const t=Object.assign({},this._signature);delete t.ad_loaded_callback,delete t.caf_loaded_ms,delete t.caf_timed_out,delete t.flex_rule,delete t.frame,delete t.js_error,delete t.no_ads_redirect,delete t.page_headers,delete t.page_request,delete t.page_loaded_callback,delete t.popup,delete t.screen_resolution,delete t.user_has_ad_blocker,delete t.user_preference,delete t.user_supports_darkmode,delete t.user_using_darkmode,delete t.zeroclick,e.append("signature",encode(t)),n.clicktrackUrl=`${TRACKING_DOMAIN}${ADS_TRACKING_URL}?${e.toString()}`}return n}))}get baseURL(){const e=new URL(this._baseURL.origin);return e.searchParams.append(ADS_PARAM,"1"),this._baseURL.searchParams.forEach(((t,n)=>{e.searchParams.append(n,t)})),e}get pageOptions(){const e=Object.assign({},this._pageOptions);return Object.keys(this._pageOptions).forEach((t=>{t.startsWith("bodis")&&delete e[t]})),e}get cannotLoadAds(){return!this.ads.loaded}get wantsToServeAds(){return new URLSearchParams(window.location.search).has(ADS_PARAM)}get adsMode(){return this.ads.loaded&&this.wantsToServeAds}get adsReady(){return this.wantsToServeAds&&!this.cannotLoadAds}get noAdsRedirectUrl(){const e=new URLSearchParams(window.location.search);return KNOWN_CAF_PARAMS.forEach((t=>e.delete(t))),`${window.location.origin}?${e.toString()}`}get callbacks(){return this.ads.toCallbacks()}toContext(){return Object.assign({blocks:this.blocks,pageOptions:this.pageOptions},this.ads.toContext())}}class CookieConsentManager{constructor(){this.injectScriptTag=()=>__awaiter(this,void 0,void 0,(function*(){return new Promise((e=>{const t=document.createElement("script");t.setAttribute("src",COOKIE_CONSENT_JS_URL),t.addEventListener("load",(()=>this.awaitConsent(e))),t.addEventListener("error",(()=>e(!1))),document.head.appendChild(t)}))}))}inject(){return __awaiter(this,void 0,void 0,(function*(){this.injected||!COOKIE_CONSENT_JS_URL||isLocal()||(this.injected=yield this.injectScriptTag())}))}awaitConsent(e){let t=0;const n=setInterval((()=>{t+=1,20===t&&(clearInterval(n),e(!0)),void 0!==window.__tcfapi&&(window.addEventListener("ConsentActivity",(t=>{const{detail:{status:n}}=t;n&&e(!0)})),clearInterval(n))}),50)}}class App{main(){var e,t;return __awaiter(this,void 0,void 0,(function*(){if(this.parkResponse=decode(),this.findDomainResponse=yield getFindDomain(),!this.findDomainResponse)throw new Error("Domain failed to load.");this.pixels=Pixels.build(this.findDomainResponse),null===(e=this.pixels)||void 0===e||e.listenForEvents(),this.adblock=new Adblock,yield this.adblock.inject(),this.google=Google.build(this.findDomainResponse,this.parkResponse,this.adblock,buildSignature({context:this.context,callbacks:null===(t=this.google)||void 0===t?void 0:t.callbacks},"click")),this.google.injectTagManager();const n=Parking.build(this.findDomainResponse,this.google);Render.prerender(n),this.cookieConsentManager=new CookieConsentManager,yield this.cookieConsentManager.inject();let i=Failed.cannotPark(this.findDomainResponse);if(i)return void(yield this.transitionToFailed(i));yield this.google.injectAds();let s=Disabled.build(this.findDomainResponse,this.adblock.state);if(s)return void(yield this.transitionToDisabled(s));const a=this.adblock.hasAdblocker();a&&this.adblock.handleAdblocked();const o=Sales.build(this.findDomainResponse);if(o)return void(yield this.transitionToSales(o));this.eligibleForZeroClick&&(this.zeroClickResponse=yield getZeroClick(this.context));const r=Redirect.build(this.findDomainResponse,this.zeroClickResponse,this.google);if(r)yield this.transitionToRedirect(r);else{if(a)return s=Disabled.build(this.findDomainResponse,this.adblock.state),void(yield this.transitionToDisabled(s));i=Failed.noSponsors(this.google),i?yield this.transitionToFailed(i):yield this.transitionToParking(n)}}))}transitionToParking(e){return __awaiter(this,void 0,void 0,(function*(){this.state=e,Render.template(e),Render.revealPage(),yield this.google.waitForBlocks(),yield this.track()}))}transitionToRedirect(e){return __awaiter(this,void 0,void 0,(function*(){this.state=e;const t=this.track();Render.revealPage(),yield waiter(e.delay,(e=>Render.loading(e))),yield t,window.location.href=e.url,log(`➡ Redirecting [${e.url}]`)}))}transitionToFailed(e){return __awaiter(this,void 0,void 0,(function*(){this.state=e,Render.message(e.message),Render.revealPage(),yield this.track()}))}transitionToSales(e){return __awaiter(this,void 0,void 0,(function*(){this.state=e,e.init(this.context),yield this.track()}))}transitionToDisabled(e){return __awaiter(this,void 0,void 0,(function*(){this.state=e,Render.message(e.message),Render.revealPage(),yield this.track()}))}track(){var e;return __awaiter(this,void 0,void 0,(function*(){if(!this.state.track)return Promise.resolve();try{const t=this.state.trackingType;return null===(e=this.pixels)||void 0===e||e.dispatchEvent({type:t}),trackVisit({context:this.context,callbacks:this.google.callbacks},t)}catch(e){return}}))}get eligibleForZeroClick(){const{cannotPark:e,canZeroClick:t,zeroClick:n}=this.findDomainResponse,{cannotLoadAds:i,wantsToServeAds:s}=this.google;return this.adblock.state!==Blocking.BLOCKED&&(!!t&&(!!e||(!(!i||s)||!!(null==n?void 0:n.reason))))}get context(){var e,t,n,i;const s=this.findDomainResponse,a=this.parkResponse,o=null===(e=this.state)||void 0===e?void 0:e.toContext(),r=null===(t=this.adblock)||void 0===t?void 0:t.toContext(),d=null===(n=this.google)||void 0===n?void 0:n.toContext(),c=browserState(),l=Object.assign(Object.assign({},null===(i=this.findDomainResponse)||void 0===i?void 0:i.zeroClick),this.zeroClickResponse);return Object.assign(Object.assign(Object.assign(Object.assign(Object.assign(Object.assign(Object.assign({app_version:APP_VERSION},s),a),r),d),o),c),{zeroClick:l})}init(){return __awaiter(this,void 0,void 0,(function*(){try{window.__parkour=this,yield this.main()}catch(e){console.error("app",e);const t=Failed.fromError(e);this.state=t,Render.message(t.message),Render.revealPage()}}))}}(new App).init(),exports.App=App}));