Abstract

Next December 2023, it will be forty-five years since the establishment of the National Health Service (Ssn). It represents an important deadline in a phase of Italian history when it is feared that the Ssn may lose its universalistic trait. The text presents the descriptive analysis of the regulations which, over time, have had the task of implementing Law 833. This is followed by a presentation of the political-economic contexts which, at a supranational, national and subnational level, have characterized the 45 years of creation of the NHS. The main thesis is that the fragility of public governance, combined with the weaknesses of the Italian economy as well as the difficult regulatory balance on which regional decentralization is based, can be considered as useful factors in understanding the slow erosion of universalism expressed by Law 833, in an era characterized as «neoliberal».