Gimbe Foundation: Health without equity – Italia needs funding and reforms
The Foundation has sounded the alarm over the 36 billion that separates our per capita healthcare spending from the EU average
‘Every year, it’s the same old story: the debate on healthcare funding flares up in the run-up to the Budget, plays out in negotiations over a few billion, and dies down straight afterwards. It is time to change course: we need resources commensurate with healthcare needs and reforms capable of translating them into genuinely accessible services, investing first and foremost in staff and in the uniform provision of Essential Levels of Care. Otherwise, the right to healthcare will remain universal only on paper, but increasingly less tangible in real life: those who can afford it pay, whilst those who cannot either wait or go without treatment. This is no longer universal healthcare, but a selection of rights based on income. In other words, a denial of Article 32 of the Constitution.” So said Nino Cartabellotta, President of the Gimbe Foundation, ahead of the debate on the 2027 Budget Bill.
An international comparison
The analysis is based on the OECD Health Statistics dataset, updated as at 17 July 2026, and the EU Commission’s 2026 Country Report: in 2025, in terms of per capita public healthcare expenditure, Italia ranked 15th amongst the 27 European countries in the OECD area and last amongst the G7 nations. Public healthcare expenditure stands at 6.2 per cent of GDP, down from 6.3 per cent in 2024 and significantly lower than both the OECD average and the average for European countries, both of which stand at 7.1 per cent. As regards per capita expenditure at purchasing power parity, Gimbe also notes that the gap compared with the average for European countries has exceeded 36 billion euros.
Fairness in the balance
In particular, in the EU Commission report, ‘for the first time, the problems facing the National Health Service are no longer viewed merely as a health protection issue but – as Cartabellotta points out – are also explicitly linked to social equity and the country’s productivity. It is no coincidence that on 10 July the Council of the EU adopted a formal recommendation urging Italy to ensure more timely access to affordable healthcare and address staff shortages in key professions’. According to Gimbe’s president, the message sent by Europe ‘is unequivocal: the deterioration of the National Health Service is no longer just a health issue but has repercussions on the country’s economic and social stability’.
Against this backdrop of progressive defunding of public healthcare, the further comment states, recent assessments by the OECD, the European Commission and WHO Europe converge on a seemingly paradoxical conclusion: the NHS continues to deliver good health outcomes, in particular high life expectancy and low avoidable mortality, but its ability to provide timely, equitable and financially accessible care is gradually deteriorating, particularly for the most vulnerable socio-economic groups.
“Fog” surrounding local healthcare
In this context – the Foundation further notes – it is becoming even more urgent to ascertain the outcomes of the reform of local care services funded by the NRRP: as of 1 September, two months before the 30 June 2026 deadline, there is still no documented public report on the full operational status of at least 1,038 community care homes and 307 community hospitals. ‘Without up-to-date data on services actually provided and available staff,’ comments Cartabellotta in conclusion, ‘there remains a real risk – one repeatedly highlighted by the Foundation – that the new facilities will remain empty shells: European targets met, instalments collected and buildings constructed, yet incapable of ensuring the local care provision for which we have gone into debt.”
