The Old Roots of the Italian Health Legislation (2025)

A history of Italy's health policy from the Republic to the new century

Modern Italy

This article analyses the development of Italian health policies in the post-Second World War period. Shortly after the setting up of the ‘Beveridge model’ and the creation of the British National Health Service, Italy also introduced a new approach to health, which became part of the Constitution. However, the implementation of the necessary reforms was delayed due to resistance from the country's institutions and government parties. The introduction of a radical health reform became possible only in 1978 through pressure generated from social conflicts, trade unions and left-wing parties. The implementation of the National Health Service encountered a number of obstacles due to the specific conditions of Italy, but also owing to changes at the international level. The neoliberal policies started in the 1980s introduced restrictions in health spending, the regionalisation and privatisation of services, and a new selective approach to health. In spite of these limitations and co...

The reform of the Italian Constitution and its possible impact on public health and the National Health Service

Health Policy, 2017

Institutional and regulatory aspects of the Italian public health service

Institutional and regulatory aspects of the Italian public health service, 2022

This short text illustrates the fundamental legislative principles that have governed the Italian National Health Service from its inception to the present day.

Barriers to Reforming Healthcare: The Italian Case

Using the conceptual lenses offered by the ideational and cultural path taken in the health care arena, this article attempts to explain the trajectory of recent major health care reforms in Italy and the reasons for their failure, as well as providing some directions for successful intervention. A diachronic analysis of the relatively under-investigated phenomenon of health care reforms in Italy is carried out, drawing on a systematic review of the Italian and international literature combined with the research work carried out by the Author. For all the three major health reforms examined, a significant gap between the authoritative policy choices taken and the overall implementation, in terms of process and system changes, can be observed, determining a growing distance between the theoretical efficiency and the practical effectiveness of the Italian National Health Service (NHS) as well as its detachment from the social system. The main obstacle to effective reform seems to be the cultural hegemony of the administrative-managerial and the biomedical paradigms, which, by reinforcing one another, yielded infertile ground for renewing in a post-modern sense the Italian NHS. The various Reforms have not been conceived to break such a positivistic monopoly in that they did not promote cultural or educational intervention. In this context, intervention that acts at a cultural level, such as reforming university education for physicians and managers or devising immigration policies to attract adequately acculturated people to the Italian NHS, seems to be the most promising. Keywords Positivism Á Healthcare reform Á Universalistic healthcare system Á

The Impact of Market Thinking and Italian Culture on National Health Service : Descriptive and Philosophical Aspects

The partitocracy of health : Towards a new welfare politics in Italy ?

Res Publica, 1970

This article illustrates the relationships between political parties and the healthcare sector in Italy since the 1950s. The several was though which parties have "exploited" health policics are explored, ranging from the selective extension of care entitlements to the various occupational categories to the clientelistic ties with doctors, from the placement of party personnell in the various administrative posts to illegal financing. The author argues that the partitocratie exploitation of the health care sector has greatly contributed to the failure of the 1978 reform establishing a National Health Service. This failure has in its turn backlashed against the partitocratic government, accellerating its demise in the early 1990s. The article concludes with some considerations on the future of Italy's health policy and, more generally, welfare state policy.

The Italian National Health Service: Universalism, Marketization and the Fading of Territorialization

Forum for Social Economics, 2022

The “Essential Levels of Care” in Italy: when being explicit serves the devolution of powers

The European Journal of Health Economics, 2005

CivilSocietyintheItalianReformedHealthcareSystem:ARoleorResponsibility?

At the turn of the new millennium the European Union (EU) catapulted into a new economic era. The golden period of the welfare state, as a solution to social inequity, started to lose ground especially in countries traditionally considered as having conservative-corporatist welfare regimes. Gradually the economic burden the welfare state had transformed itself into became too conspicuous for governments to conceal from other EU member states, the global economic scenario, the sharp eyes of the media and community at large. Due to austerity measures, the guarantee of universal access to healthcare which civil society had gained in exchange of votes started to crumble and, as public debts become more grievous, citizens have started giving up hope on politicians’ promises of finding solutions. In this article we pose the question as to whether civil society can merely be acknowledged as playing a role in healthcare, or if the reform measures adopted are demanding that civil society shoulders the responsibility which states seem unable to handle any longer. In the first part of the article the healthcare system in Italy, the third largest economy in the Euro-zone and a welfare system based on solidarity, is presented as a case study of how the principle of universal healthcare has slowly been nibbled at since the 90s. In the second part we argue that Italian civil society, despite a period characterised by a long transition of administrative and healthcare reforms, plays more than a key role in guaranteeing community wellbeing.

Solidarity and the role of the state in Italian health care

Health care analysis : HCA : journal of health philosophy and policy, 2000

The article deals with the issue of solidarity in health care, with particular reference to the Italian context. It presents the difficulties of the Italian NHS and assesses the current proposal to counter the crisis of the Welfare State by giving up institutional arrangements, in order to favour the so-called 'social private'. Moreover, it addresses the question of prioritization and targeting in the context of health care, arguing for the insufficiency of the standard approach of neutral liberalism, and showing how the concept of solidarity might help to develop a different account. Lastly, it discusses the case of organ transplantation in Italy, as an example of solidarity-inspired health care policy.