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

AbstractThis 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 contradictions, the Italian healthcare system has been considerably successful, leading to strong improvements in health and to a life expectancy at birth among the longest in Europe. The recent developments – and the experience of the pandemic – confirm the important impact of a public, universal health service and, at the same time, the persistent policy efforts aimed at weakening its reach.