Italy has the second-best healthcare system in the world according to the World Health Organization. It also has some of the healthiest people and a high life expectancy. Italy has universal health coverage and a mixed public-private healthcare system. Its public healthcare system was created in 1978, when the government established the National Health Service called Servizio Sanitario Nazionale (SSN). The SSN automatically covers all citizens and legal residents. Undocumented immigrants can receive urgent and essential care.
Healthcare in Italy is decentralized. The central government is responsible for policies as well as establishing funding and resources. Regional governments are in charge of delivering care through local health units. They are responsible for the delivery of outpatient, hospital and primary care, as well as health services related to social care. The SSN is financed through taxes. There is a corporate tax which provides around 18.6% of the funding. These taxes are pooled nationally and then allocated back to the regions and are typically allocated in relation to a region’s contributions. Then there is the national value-added tax revenue which accounts for around 60% of the funding. It is redistributed to the regions with low funding and resources to provide essential services. Regions are also allowed to generate their own revenue.
The public healthcare system in Italy is mandatory. It is the responsibility of the central government to define the national benefits package that is offered to every resident. It includes primary, outpatient, inpatient, maternity and home care, as well as pharmaceuticals. Under the SSN, patients are free to choose their primary doctor but not any specialists. Dental care is free in emergency cases and for those 16 and under. Enrolling in only private care is not allowed but there are complementary plans available. Around 10% of the population has some form of voluntary insurance. These plans usually cover what is excluded by the national benefits package. They can also offer a higher standard of comfort and privacy, and more choices in providers. There are two kinds of private health insurance. Corporate which is provided by companies and noncorporate and which individuals buy themselves.
Healthcare costs in Italy are typically low. Primary and inpatient care are free at the point of use as well as most preventative procedures. However, there are copays for some prescribed procedures and specialized visits up to a certain point. Some prescriptions also require copayments. There is a tax-credit available for out-of-pocket costs over a certain amount. Around 23% of total health spending was from out-of-pocket costs, mostly for drugs and dental care. There are some exemptions from costs, such as age limits and those with long-term illnesses and disabilities.
While healthcare in Italy is considered among the best, it is not perfect. Doctor’s offices tend to be crowded with long wait times. You cannot choose your own specialist and it can sometimes take months to be seen which can delay diagnosis and treatment. Also, the way funding is set up there can be inequalities between regions especially those in the south. Despite some of the downfalls, healthcare in Italy is often seen as an example of a well-functioning public healthcare system.