Keywords: Universalism; Health Care Systems; Appropriateness; Sustainability; Health Spending.
The economic sustainability of healthcare systems is at the center of the political debate in many countries. The issue is often brutally reduced to the amount of public resources that are needed to guarantee universal access to care. However, the sustainability of public healthcare systems is first and foremost a cultural and political issue: to what extent are we willing to preserve the founding principles of our healthcare system and to guarantee a high quality of care to all citizens, despite the economic crisis? According to the UN, countries with very good health statuses have all some form of universal coverage. By analyzing the main dimensions of universalism - i.e. the population enjoying healthcare protection, the range of healthcare services provided and health expenditure - the authors explain why Italy should re-assess the main purposes of a universal healthcare system and move away from a strictly technical and financial approach.