The strenghts and weaknesses of Italy’s National Health Service are discussed in this article, in light of the Covid- pandemic, which has shown the crucial importance of universal public health systems. Key weaknesses include the reduction in staff, lack of turnover of doctors and nurses, increase in precarious work, impoverishment of territorial services, a poor culture of prevention, high social and territorial inequalities, poor commitment of top decision-makers. At the same, the heritage of the original approach of the NHS could be revived, emphasising preventive medicine in communities and workplaces, strengthening territorial services and social assistance, with the goal of a renewed welfare system