“The Italian state is a parliamentary, democratic republic with a multi-party political system. Italy has been a democratic republic since 2 June 1946, when the monarchy was abolished by popular referendum. The political system is based on the 1948 Constitution. The Chamber of Deputies (630 members) and the Senate (315 members) form the bicameral parliament, whose members are directly elected for five years by universal suffrage. The President of the Republic is elected for seven years by a joint session of the Chamber and Senate and is the formal head of the state. The Prime Minister must be endorsed by, and have the confidence of, both parliamentary houses and is ultimately nominated by the President. The Prime Minister is usually the leader of the party that has the largest representation in the Chamber of Deputies. The judiciary system is independent of the executive and the legislative branches and is headed by the High Council of the Judiciary.

“Italian politics has been characterized by high levels of government turnover since the beginning of the republic; indeed, there have been 62 governments since 1946. From 1948 until the late 1970s the Prime Minister was consistently from the Christian Democratic Party. Coalition governments with roughly the same party configurations promoted a relative period of continuity and stability to Italy’s political situation during much of the post-war period, with the clear intention of keeping the Italian Communist Party (PCI) out of power in order to maintain Cold War equilibrium in the region. During 1976–1979, the Communist Party voted in support of the government (which included the Christian Democratic Party, the Socialist Party, the Social Democratic Party and the Republican Party) for the first time, although it did not formerly enter the government coalition.”

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.

“The Constitution organizes Italy’s territory into 20 regions, which are extremely varied. They differ in size (Piedmont is 25 000 km2, while Valle d’Aosta is only 3000 km2), population (Lombardy has 15% of the total population, whereas Molise has less than 1%) and levels of economic development. The regions also differ in population age distribution. For example, an average of 20.8% of Italy’s population is aged 65 years or older; southern Italy has fewer (19.5%) and central and northern Italy has more (22.4%). Each region is governed by an Executive and a Regional Council, both of which are democratically elected. The regions have exclusive legislative power with respect to any matter not expressly reserved under national law (Constitution article 117). Yet their financial autonomy is quite modest: they hold 20% of all levied taxes, mostly used to finance the regionally based health-care systems. This is the result of the reform passed in 1997 – known as the Bassanini Law – that significantly extended the powers transferred to regions through the principle of subsidiarity.

“In particular, responsibility for regulating, planning and organizing health-care delivery has been transferred to the regions, and the central government retains responsibility over the basic principles and institutional rules of the system and as such functions by approving the National Health Plan, allocating funding and defining clinical and accreditation guidelines. The gradual devolution of political power during the 1990s runs parallel to the fiscal reform passed in 2000, which (in theory) granted regions significant autonomy over revenue in the regional budget and complete autonomy over the allocation of funds (Constitutional Law N. 3/2001) (see Chapters 3 and 7). However, the autonomy over revenue has been modest so far.

“The 20 regions are subdivided into 110 provinces. The provinces are led by a president and a council, both of which are elected by city mayors and city council representatives of the respective provinces. Provincial councils comprise a minimum of 24 members and a maximum of 45 depending on population density. In addition, each province has a prefect who represents – and is appointed by – the national government. The basic unit of local government is a municipality (comune), which may range in size from a small village to a large city such as Rome. Italy has about 8,100 municipalities, many of which are small villages with an ancient tradition of independent self-government; only 8% of total municipalities have more than 15 000 inhabitants. A council elected for a five-year term by universal suffrage governs each municipality and mayors of cities and towns are also elected.”

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.

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 Sept. 20, 2022 by Doug McVay, Editor.