Italy and the G7: last in healthcare funding, but second in life expectancy

We are second among the seven big countries of the Earth that are part of the exclusive G7 club for life expectancy and avoidable mortality only after Japan, but we are last both in terms of how much we invest overall to cure ourselves and in terms of public spending. We are then second again for the number of doctors (after Germany), dispelling at least in part the myth of the shortage of white coats (which actually applies to some medical specialities) and confirming instead Italy's real problem, namely the serious alarm over the lack of nurses, which we have less than all of.

Finally, we are dead last in terms of the level of salaries of health personnel, which is one of the main reasons for the flight of doctors and nurses from our hospitals to foreign countries or the private sector, and on which the government will again try to make amends in the forthcoming manoeuvre.

This, in a nutshell, is the identikit of the Italian health system on the eve of the opening of the G7 Health Summit that Italy is hosting in Ancona from 9 to 11 October, where, among other things, prevention, antimicrobial resistance, which risks being the new pandemic, and the 'one health' challenge, i.e. the fact that human and animal health are increasingly linked, will be discussed. An occasion that will showcase our National Health Service, as the Minister of Health Orazio Schillaci also recalled: 'Other countries look very carefully at our SSN, which is a universalistic system that treats Italian citizens free of charge every day. It is an asset of this country that we absolutely want to preserve and strengthen'.

But what do the basic data (OECD and Eurostat to 2022) comparing the seven countries (Italy, Canada, France, Germany, Japan, the United Kingdom and the United States) that are part of the G7 countries say about healthcare? On closer inspection, the Italians are doing quite well, but it is the organisation of the system and the funds to make it work well that is losing out to its partners. Italy, as is well known, is one of the oldest countries in the world, with the percentage of over-65s at 23.8 per cent, second only to Japan's 28.9 per cent, and with the United States in last place with 16.8 per cent. The same goes for life expectancy at birth, 82.7 years for Italy, surpassed only once again by Japan's 84.5 years, while last in the ranking are again the United States where life expectancy at birth is 76.4 years. We are second among the G7 also for avoidable mortality (deaths per 100,000 inhabitants), which in our country stops at 91 (only Japan is better with 85), while the worst result is once again the United States, which, according to OECD data, could avoid 238 deaths per 100,000 inhabitants.

So far the glass is half-full, that is, the fact that Italians are in good health, thanks also to good lifestyles, and despite the fact that the glass is half-empty it says that Italy has a problem with spending and investment on healthcare. Among the world's big countries, we are the country with the lowest incidence of healthcare spending on GDP: in 2022 we were spending only 9 per cent, while others were spending double figures, such as the USA at 16.6 per cent, Germany at 12.6 per cent, and France at 12.1 per cent. Above all, when it comes to public health spending (or through insurance schemes), we are far behind the others: in 2022 in Italy the SSN spent 6.8% of GDP, a figure that is growing due to the tail end of the pandemic (in 2023 it dropped to 6.2%), against, for example, 10.3% and 10.9% in France and Germany. It is no coincidence, however, that we are third (behind the USA and Canada) for healthcare costs that citizens pay out of their own pockets (2.2% of GDP).