The Italian NHS, the Public/Private Sector Mix and the Disparities in Access to Healthcare

The Italian healthcare system is based on a combination of the public and private sectors. The public component is represented by the National Health Service (NHS), financed through general taxation. One third of the NHS budget, however, is used to finance private providers. Albeit the Italian National Health Service resolves to be universalistic and comprehensive, it fails to finance all the healthcare needed by Italians, who bear out-of-pocket costs for part of their pharmaceutical treatments, dental and other specialist care. The private component corresponds to 23 % of the total healthcare expenditure and is largely out-of-pocket. Healthcare users who have more disposable income can afford additional services to those provided by the NHS, shorten waiting times and have greater freedom of choice of provider. Conversely, individuals on low income must settle for the healthcare services provided by the public system and, in some cases, are unable to afford certain types of care. In addition to disparities related to income, there are also regional disparities: the quality of the services provided indeed varies depending on the region of residence, and the gap is especially large between the central-northern and the southern regions.