Per la sanità un decennio di contraddizioni e prove tecniche di stabilità

According to a new trend in European health care systems, Italian National Health Service’s governance has been recently characterized by an increasing centralization. During the last decade, central and regional governments defined the Health Stability Pact, in order to contain public health expenditure growth and to reduce regional trend to present deficit budgets relying on central bail out. The new governance made clear the existence of large differences among performing and underperforming regions. Regions strongly in deficit are now compelled to adopt corrective measures under close control of the central government. In particular the fulfilment of the deficit reduction Piano is an essential condition to the delivery of founds standing by assignments. The paper discusses successes and risks following the application of the Health Stability Pact even relating to the new fiscal federalism law and the maintenance of public and national character of Italian health care system.