Abstract

Italian public healthcare is experiencing difficult times: the system is underfinanced and understaffed, privatization processes are accelerating, the values at the root of the National Health Service are undermined. This article examines the expansion of private activities in healthcare in the last forty years, setting the Italian case in the context of global changes in health policy and neoliberal priorities. Different dimensions of the expansion of private activities are investigated, including the rise of activities funded by public resources and carried out by private providers, of household «out of pocket» expenditure for health services, of private insurance companies. A sequence of policy turns has allowed such developments, with the result of seriously weakening the universal and public nature of Italy’s health service.