Universalism and public service in Italy’s health policies

The challenges of universalism in health have again became a topical question. A reflection of Italy’s experience in health policies requires starting again from the basic concepts at the root of the issue. The right to health is a fundamental human right, a key social right and a condition of individual freedom. Its universality and effectiveness are necessary conditions for making the right to health enforceable. The tool for achieving these objectives is the National Health Service, Italy’s Servizio Sanitario Nazionale (SSN). In recent years, a range of narratives and proposals have led to a limitation of universalism, recasting it in differentiated, diminished terms. Such arguments included the economic “unsustainability” of public healthcare, the greater efficiency of private provisions, the possibility to allow a high-income citizens to opt out of the SSN.