Would a Berlusconi return hurt Italy?

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Silvio Berlusconi is making a fourth run for Prime Minister in Italy's upcoming parliamentary electionsMonti leaving is the first big test for Italy's bond market since the ECB vowed to save the eurozone in July, Spiro saysSpiro says developments in Italy show investors should start paying more attention to country-specific risksEditor's note: Nicholas Spiro is managing director of London-based Spiro Sovereign Strategy, a niche consultancy specializing in sovereign credit risk. Spiro advises private and institutional clients on qualitative aspects of sovereign risk, with a particular focus on Europe.

(CNN) -- He's back. Having kept a relatively low profile since being forced to step down as Italy's premier last year, Silvio Berlusconi, the bad boy of Italian politics, has decided to run for the fourth time as the centre-right's prime ministerial candidate in a keenly awaited parliamentary election likely to take place in February.

Italy needs a Berlusconi comeback like it needs a hole in the head. The scandal-plagued Berlusconi, who was recently sentenced to four years in prison for tax fraud but has a knack of successfully appealing against his convictions, epitomizes the dysfunctional nature of Italian politics, with its discredited leaders and unstable governments.

Read more: Is the eurozone crisis almost over?

Over the past year or so, Mario Monti, Italy's respected technocratic prime minister, has drawn attention away from these failings by restoring credibility to Italian policymaking. The problem was that Monti, who took over from Berlusconi in November 2011 in the face of a bond market crisis, was always dependent on the parliamentary support of Berlusconi's People of Liberty (PdL) party to govern.

He now no longer has the PdL's backing and says he'll resign as soon as next year's budget is passed. So what next for Italy, and is a "Berlusconi sell-off" in the bond market in the offing?

To be sure, Berlusconi's comeback is not entirely unexpected and is more about the implosion of, and dramatic loss of support for, the PdL (not to mention its dependence on Berlusconi for most of its funding) than anything else.

Read more: The eurozone's reluctant leader

The real question, therefore, is whether investors have become too complacent about Italy in their expectation that policy continuity under the next government - which may yet include Monti - is more or less assured. I suspect they have to a degree and are now staring at the uncertain prospect of a post-Monti political landscape in Italy.

Fortunately for Italy, the bond-buying programme of the European Central Bank (ECB) is providing a powerful counterweight to concerns about Italian politics. If Berlusconi's party had withdrawn its support for Monti's government before ECB president Mario Draghi promised in late July to "do whatever it takes" to save the eurozone, Italian yields would have already risen sharply.

This is not to say that investors won't start to reprice Italian credit risk in the coming days and weeks. Rather, it suggests that the scope for a sharp and disorderly sell-off akin to the one Italy suffered in November 2011 is quite limited.

Still, Monti's decision to stand down as premier once parliament approves the 2013 budget provides the first big test for Italy's bond market since the ECB-driven rally in Italian debt began in late July. Having shone mostly on Spain over the past few months, the spotlight of the markets is now shifting to Italy.

The most important priority for Italian policymakers is to maintain confidence in the country's huge stock of government debt, the largest in the eurozone in absolute terms and the second-largest as a share of GDP after Greece. This is why Italy's upcoming government bond auctions will be scrutinized for any sign that investors are losing confidence in Italian debt - particularly since foreign buyers of Italian debt are already few and far between.

Perhaps the most salient point about the latest developments in Italy is that investors should start paying more attention to idiosyncratic, or country-specific, risks. Just because the ECB is prepared to intervene forcefully in Italian and Spanish bond markets does not mean that the underlying problems of the eurozone's third and fourth-largest economies respectively are being addressed.

Indeed, quite the opposite. Italy remains mired in recession and now faces weeks of political uncertainty at a time when it can least afford it.

The opinions expressed in this commentary are solely those of Nicholas Spiro.

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Medical Travel - How to Plan For the Return Home

After having surgery in Mexico, the last thing a patient should be worrying about is the logistics of your recovery. The key to successful health travel is planning. The patient needs to know exactly where he or she will be every step of the way before ever getting on the plane. Post-operation logistics, hotel or hospital stay arrangements should all be taken care of. But with a little bit of planning, the entire trip can be stress-free, allowing the patient to focus on healing.
After Mexico Medical Procedures
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However, most people who choose medical travel are looking to have more major procedures performed. For many of these procedures, patients need to stay in the area to be monitored for several days after, and some of them may even require patients to be in the hospital for monitoring. All patients should check with their physician before the procedure, and make sure they know how long they'll need to stay in the country afterward.
If the patient is planning a trip without the aid of a company, hotel fare can be steep. A good health travel coordinator can get significant discounts, allowing patients to stay in the area at a much lower cost. Nonetheless, medical travel is still much cheaper than domestic procedures, even if patients end up paying full price for hotel accommodations. Obviously, if the patient is going to be staying in a hospital, he or she will have to discuss the rate in combination with other individual procedures. Patients should be careful to choose a good hospital - it is vital to get good care before, during, and after each procedure. Again, a good medical travel company can help here, because they will know what the best hospitals are without having to do extra research.
Heading Home After Medical Travel
The most important thing to consider after health travel is the state of a patient's medical records. If the procedure has been at all major, the patient will need to get a full record of the procedure to the doctor who will be following up care at home. If the patient worked with a company thus far, it is very likely that they will be helping to establish care during your time at home, and they will almost certainly be able to facilitate the prompt and thorough transfer of all relevant medical records. If a patient is not working with a company, it is often wise to set up a record transfer before ever going in for the procedure. Especially if a patient expects to be traveling alone, without family or friends able to interface with the hospital during the recovery period, planning as much in advance as possible is a tremendous help.
The Importance of Aftercare
Once the patient have returned home and given all medical records to the local physician, he or she should make sure that all instructions given by the surgeon are followed as closely as possible. Patients should never hesitate to ask any questions they might have, and should absolutely contact their regular doctor or the surgeons who performed the Mexico medical procedures in question if any parts of the instructions are unclear. Almost every surgery available through health travel requires certain careful steps after the work is completed, from avoiding certain situations to changing lifestyle to taking certain medications. If the patient doesn't follow these steps exactly, it can seriously undermine the healing process.
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