Keywords: Government Expenditure and Health; State and Local Government - Health; Health Insurance, Public and Private; Health- Government Policy.
Health care policies are part of the national welfare states and have been involved in the broader trends of welfare reforms of the last decades. They have been part of the process of recalibration of the Italian welfare, even if they have not been characterized by dramatic reforms (as it has been the case of pensions and labour market policies). Health care has remained at the margin of the political debate but has experienced a trend of incremental and hidden reform. Reforms have been marked by cost containment measures, and the rationalization of hospital and care services. The aim of the article is to analyze the impact of the Great Recession in combination with the renewed EU governance of healthcare and the long-term austerity trends that have characterized Italian health care. The authors argue that the policy field has seen the acceleration of policy changes (with the double move towards recentralization of competences and privatization) in the aftermath of the crisis. This has happened through a typical «quiet politics», where reforms are set without any major political and public debate.