Health professions: doctors get the richest pensions, biologists and psychologists at the back

The operation of the Civi, on the other hand, is based on making a reconstruction from the contributions in the health worker's contribution statement.

The pension is determined on the basis of the income of the entire professional career.

There are currently more than 66,000 general practitioners. There are more than 37,140 ordinary pensioners who receive the prevailing pension from the General Practitioners' Management, and they receive pensions totalling 1,599,712,608 euro (56 % of the total amount of benefits) with average annual gross payments of 50,500 euro.

Among them are family doctors, paediatricians of free choice, but also contracted continuity of care and territorial emergency workers and some former 118 workers who have gone into dependency. The contributions come directly from the health companies, which deduct them at source.

The management also includes outpatient specialists and service medicine workers who have switched to an employment relationship while maintaining their social security position with Enpam. Today everyone, contracted and employed, has the same contribution rates. But the management has historically ensured forward-looking contribution levies, which allow today's pensioners to benefit from adequate allowances. There are currently more than 14,700 outpatient medical specialists. The number of ordinary pensioners for the year 2024 is 14,821 and the related amount paid out is € 363,826,878, which corresponds to 12% of the total amount of ordinary pensions of all Enpam management schemes. The average annual amount of new ordinary pensions payable by the management is about € 44,800.

The number of external ad personam specialist doctors is currently 474, and the number of external INPS contracted doctors is 749. There are 1,894 professional societies under Article 1, Paragraph 39 of Law 243/2004, which declared a turnover in 2024, and 14,606 beneficiaries of the contribution.

The number of ordinary pensioners for the year 2024 is 2,191 and the related amount paid out is € 34,765,964, which corresponds to 1% of the total amount of ordinary pensions of all Enpam management schemes.

On the other hand, new external specialists, who practise their profession while no longer being paid directly by the National Health Service but by accredited facilities, have been receiving a 2 per cent contribution on their clients' turnover since 2004. In addition, in 2024 a 4% contribution was collected from members who benefit from the above-mentioned 2% contribution.

There are currently about 217,000 freelance doctors. The number of ordinary pensioners for the year 2024 is 66,987 and the related amount paid out is € 394,876,450, which corresponds to 14% of the total amount of the ordinary pensions of all Enpam management schemes. The average annual amount of new ordinary pensions paid out by the management is approximately €19,000 (all pension payments of less than €500 per month have been excluded). The freelancer who takes €19,000 a year in pensions may be a disappointment since his main source of pension is in Quota B. However, this figure is distorted by several factors. The first is that a proportional contribution on income from freelance work has only existed in Enpam since 1990 (for dentists even since 1995), and the contribution rates have always been varied and initially very low.

Consider that in the early years the full rate was 12.5 per cent, and only up to a limited income ceiling, while the reduced contribution was 2 per cent for those with another pension position. Average pensions in the past are therefore not predictive of future pensions, which tend to increase.

There are 365,318 members of the Quota A management, of whom 7,695 are students from the fifth year of their degree course. The number of ordinary pensioners for the year 2024 is 128,936 and the relative amount paid is € 483,152,773, which corresponds to 17% of the total amount of ordinary pensions of all Enpam management schemes.

The average annual amount of new ordinary pensions paid by the management is around 4,000 euro. A pension, in this case, truly modest. Modest as well as modest, however, have been the annual contributions, especially in the past, which have constituted a 'montante' (the total of contributions paid) to which the percentages used (the same as those used by the Inps) result in low treatments. However, looking at the years of birth, it can be seen that out of these 15,000 pensioners with prevailing Quota A pensions, only 74 are over 70 years of age. Almost all the others are health care workers who started to receive this first Enpam pension while waiting to meet the requirements to receive a larger one from Enpam or Inps.

This tends to be the case of formerly self-employed professionals who have paid no other contributions (remember that before 1990 Quota B did not exist) or who have taken advantage of the possibility of withdrawing their other contributions paid to other Enpam management schemes, renouncing the pensions to which they would have been entitled. The receipt of an Enpam pension, in this case, of a small amount, which, in any case, always corresponds proportionally to a higher sum than that paid, does not generally correspond to hardship. The proof is offered by the number of ordinary pensioners who benefit from the Inps minimum integration: they are 258 out of 140 thousand, i.e. less than 0.25 per cent.