In 2025, healthcare spending will stand at 6.2 per cent of GDP, with Italia coming last amongst the G7 countries
According to Gimbe, the latest available figures are fuelling political tensions and putting all the regions in a difficult position, caught between the obligation to guarantee Essential Levels of Care and that of keeping their finances in order
In 2025, per capita public healthcare expenditure places our country in 15th place amongst the 27 European countries in the OECD area and in last place amongst the G7 nations. “Public underfunding of healthcare is no longer just an issue for those in the sector, but a structural problem that has weakened the National Health Service and undermined the enforceability of a fundamental right”, stresses Nino Cartabellotta, president of Gimbe, commenting after the summer break on the latest analysis of healthcare spending in OECD countries, carried out by the Foundation ahead of the start of discussions on the 2027 Budget Bill.
In Italia, public healthcare expenditure in 2025 stood at 6.2 per cent of GDP, down from 6.3 per cent in 2024 and well below the OECD average of 7.1 per cent. This situation “fuels political tensions and creates difficulties for all regions, caught between the obligation to guarantee Essential Levels of Care and that of keeping their finances in order. But it is the public who pay the highest price: out-of-control waiting lists, emergency departments on the brink of collapse, a shortage of GPs, increasingly marked regional and social inequalities, and a growing reliance on private healthcare. The result? Impoverishment and indebtedness among households, to the point where people are foregoing diagnostic tests and specialist consultations: a phenomenon that affected 5.8 million people in 2024 – almost one in ten”, continues Cartabellotta.
Different funding schemes
Gimbe’s analysis is based on the OECD Health Statistics dataset, updated on 17 July. The comparisons relate to public healthcare expenditure, expressed both as a percentage of GDP and in dollars per capita at current prices and in purchasing power parity (PPP). When interpreting the data, it should be borne in mind that each country’s public healthcare expenditure comprises various funding schemes, one of which is generally predominant: general taxation (e.g. Italia, the United Kingdom), compulsory social insurance (e.g. Germany, France) and compulsory private insurance (e.g. the USA, Switzerland).
In the EU, 14 countries spend more than Italia
Whilst public healthcare expenditure in Italia in 2025 amounts to 6.2 per cent of GDP, there are 14 European countries within the OECD that allocate a higher proportion of GDP to this item than Italia does: the difference ranges from +4.8 percentage points in Germany (11 per cent of GDP) to +0.2 in the Slovak Republic (6.4 per cent of GDP). Per capita public healthcare expenditure in Italy stands at $3,952: a full $909 less than the OECD average ($4,861) and a full $1,013 less than the average for European countries ($4,965). Among the Member States of the European Union, 14 spend more than Italia: ranging from $47 more in Spain ($3,999) to $4,774 more in Germany ($8,726).
In 2011, the divergence between Italia and the EU average began
In short, “Italia is now firmly lagging behind: even the Czech Republic, Slovenia, Poland and Spain are ahead of us, whilst only a few countries in Eastern and Southern Europe remain behind us”, Cartabellotta points out. Until 2011, per capita public healthcare expenditure in Italia was broadly in line with the European average. Since then, the gap has widened, increasing further during the pandemic years, when other countries invested far more than Italia, then in 2023–2024, when the increase in Italia was lower than the European average; and in 2025, when Italian public healthcare expenditure remained broadly stable. In 2025, the gap compared with the average for European countries in the OECD reached $1,013 per capita at current prices and in purchasing power parity terms, corresponding to €612.4 per person.
