ABSTRACT
The chapter starts from Italy’s uneven scores in the major international rankings of the performance of national healthcare systems. To understand the reasons for the scores assigned to the Italian National Health Service, we first scrutinize the specific features of the various ranking systems and the data sources they use, the indicators on which they are based and how often they are updated in order to provide a clear picture of the characteristics and limitations of the information they collect. After determining why the international ranking systems’ assessments of Italy vary so much, attention turns to the characteristics of the Italian National Health Service, with an overview of its most recent changes and of the widening inequalities—regional and otherwise—that it displays. In particular, the chapter documents the considerable differences between the regional health services, their difficulties in coordinating with each other, and the changing face of the public health system as a whole, whose successive reformulations have gradually shifted its mission. Now, 40 years after the Italian National Health Service was set up, the question is if we can still speak of universal healthcare.
