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“The 1978 reform (Law No. 833/1978) that created the SSN [Italy’s National Health Service] introduced universal health-care coverage for Italian citizens and those legally residing in Italy. It established human dignity, health needs and solidarity as the guiding principles of the system. The main aims of the reform were to guarantee everyone equal access to uniform levels of care, irrespective of income or location; to develop disease prevention schemes; to control health spending; and to guarantee public democratic control. A mixed financing scheme was established that combined general taxation and statutory health insurance contributions, progressively moving to a fully tax-based system. The new health-care system was partly decentralized, with national, regional and local administration levels. The central government was responsible for financing, namely defining the criteria for the distribution of funds to the regions, attempting to progressively reduce regional imbalances and distributing funds; it was also responsible for planning through
a three-year National Health Plan (Piano sanitario Nazionale – PSN). Regional health authorities were responsible for local planning according to health objectives specified at the national level, for organizing and managing health-care services and for allocating resources to the third tier of the system, then known as ‘local health units’ (Unità Sanitarie Locali – USLs). The USLs were operational agencies responsible for providing services through their own facilities or through contracts with private providers. They were run by management committees elected by assemblies of representatives from local governments.”

Source: Ferré F, de Belvis AG, Valerio L, Longhi S, Lazzari A, Fattore G, Ricciardi W, Maresso A. Italy: Health System Review. Health Systems in Transition, 2014, 16(4):1–168.

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“As a step towards decentralizing fiscal powers so as to give more financial responsibilities and powers to each region, a Decree in 2000 (No. 56/2000) set out a timetable to eventually abolish the National Health Fund, which was used to collect and distribute central resources to regional health-care systems.³

“Various regional taxes became the sources of health care funding. Regions unable to provide the basic package of health services with their own resources would receive additional funding from a newly created National Solidarity Fund. Money from this fund is allocated annually based on criteria recommended by the government and the Standing Conference on the Relations between the State, the Regions and the Autonomous Provinces (or the State-Regions Conference, for short). Table 2.1 summarizes the main historical landmarks in the development of Italy’s health-care system.”

Source: Ferré F, de Belvis AG, Valerio L, Longhi S, Lazzari A, Fattore G, Ricciardi W, Maresso A. Italy: Health System Review. Health Systems in Transition, 2014, 16(4):1–168.

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World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated October 6, 2023 by Doug McVay, Editor.