The Italian National Health Service Law (Servizio Sanitario Nazionale – SSN) was established on December 23, 1978, to guarantee health as a fundamental right of every individual and as a public good for society. This comprehensive healthcare law set the foundation for universal and equitable access to healthcare services across Italy, ensuring that all citizens are treated with dignity, equality, and respect. The SSN integrates prevention, diagnosis, treatment, and rehabilitation services while coordinating with environmental health, food safety, and occupational safety measures.
The SSN prioritizes health promotion and disease prevention as core components of its mission. The key objectives include developing health awareness, preventing diseases, ensuring timely diagnosis and treatment, and supporting rehabilitation for physical and mental health conditions. It also addresses environmental health risks, regulates pharmaceutical standards, and emphasizes professional development for healthcare workers. Healthcare services are delivered without discrimination, with a commitment to equality of access. To achieve these objectives, the system is designed to coordinate healthcare services at all levels of government—national, regional, and local—ensuring the participation of citizens and local communities.
Since its inception, the Italian National Health Service Law has undergone multiple reforms to enhance its effectiveness and sustainability:
- 1992-1993 Decentralization Reforms:
These reforms transferred greater administrative and financial control to regions, enabling them to tailor healthcare services to local needs. Hospitals and other providers began competing within a public-private healthcare market. - 2001 Constitutional Reform:
Healthcare became a concurrent responsibility between the State and regions, giving regions increased control over healthcare organization but also creating challenges with regional disparities in service quality and availability. - Essential Levels of Assistance (LEA):
To address healthcare inequality, LEA standards were introduced to guarantee a minimum level of services across the country. - Response to the COVID-19 Pandemic:
The COVID-19 crisis underscored the importance of robust public health infrastructure. Emergency investments were made to strengthen hospital capacity, digital health services (including telemedicine), and pandemic preparedness.
The creation of the Italian National Health Service marked a shift towards universal health coverage by ensuring that all citizens have access to comprehensive health services regardless of their socioeconomic status. The law emphasizes preventive care and social equity, reflecting a broader European trend during the 20th century that recognized health as a fundamental right.
This system’s decentralized model allows regions to tailor healthcare to local needs, but it also requires strong coordination to prevent inequalities in service delivery. The focus on environmental and occupational health demonstrates a progressive approach, integrating public health considerations with broader social and economic policies.
