The Italian National Health Service after the Economic Crisis: From Decentralization to Differentiated Federalism

• Main Author: Stefano Neri
• Format: Article
• Language: English
• Published: Centro de Estudos Sociais da Universidade de Coimbra 2019-06-01
• Series: e-cadernos ces
• Subjects: decentralization; economic crisis; governance; health care; national health service
• Online Access: http://journals.openedition.org/eces/4403

This essay analyses the evolution of the National Health Service (NHS) in Italy after the beginning of the financial crisis of 2008, focusing on some trajectories of change underway in the NHS governance. It starts with a reconstruction of the economic and financial framework of the NHS in the last 10 years, briefly describing the austerity policies implemented in the health sector. It then outlines the NHS institutional framework as it emerged from 1990s reforms, which is based on intergovernmental relations and joint policy-making between the State and the Regions. In the third part, it shows how the response to the economic crisis has had a significant effect on these relations, triggering a transformation in the NHS governance. This change, which is far from being concluded, could seriously undermine the universalistic nature of the Italian NHS and its ability to pursue the values of equity and solidarity, especially at a territorial level.