Abstract

The paper deals with the critical issues in the Italian national health system. The pandemic has shown the effects of the continuous reduction of total spending, due to the need of reducing Italian fiscal deficits, leading to the reduction of beds in hospital (including intensive care) number of doctors and nurses. Moreover, a reform of 2007 aiming at the diffusion of decentralized structures (Case della Salute) has been only partially implemented. An economic analysis shows that – contrary to the present mainstream approach – the public structure must remain the leading principle of a health system, according to the guideline of the Italian constitution. The paper shows the present critical issues as far as the number of personnel and the organization of decentralized structures are concerned. The conclusion is that the resources of the NRRP cover only a fraction of the present gap. Further financial effort is needed heal