What does insurer-controlled healthcare cause doctors' treatment decisions to be affected by?

Can someone me? so i'm writing a current events article is rome and i choose to write about the trash problem they have going on. i decided to use the article from ccn rome in ruins: the ancient city lain waste. i have a question if someone could answer this for me, what caused this? why isn't trash being taken care of and cleaned up? 'i'm not completely sure where this question should go but i decided health because this is kinda a heath hazard? '