Health care policy and politics in Italy in hard times

This time is different. According to Pierson, welfare states emerged virtually unscathed from the strains of the economic crises of the 1970s and the 1980s and that they bounced back thanks to their enduring popularity and powerful constituencies. By contrast, the current financial crisis is one of those unexpected and rare emergencies (the prototypical ‘black swan’) capable of producing powerful short-time effects and long-lasting political and institutional change. Even health care systems, the most immovable objects of the ‘frozen’ landscapes of welfare states, are on the move to a destination unknown. Italy is the poster child for creeping corruption of the basic principles of its Servizio sanitario nazionale (SSN), established in 1978 along the lines of the UK National Health Service (NHS). Although there is no direct assault on the SSN and its universalism, the unprecedented cutbacks in health care expenditure are not just transient ‘haircuts’ but convenient avenues for reductions in social rights. In this respect, the Italian case bears watching by other countries.