Abstract

In early 2020, the Italian National Health Service (NHS) was affected by four kinds of distortion: cultural, penalising health prevention; functional, giving priority to hospital care; institutional, with a decentralised system lacking inter-regional solidarity; redistributive, tending to a differentiated universalism. These distortions strongly conditioned its ability to respond to the Covid-19 pandemic. Selected measures represented mostly simple adjustments adopted in the emergency and determined by path dependency. Although they share the same critical features, reforms included in the 2021 National Recovery and Resilience Plan attempt a more significant action on the distortions, in order to pursue wider and partly structural changes.