The Impact of Market Thinking and Italian Culture on National Health Service

In Italy current problems concerning the relationship between medicine and the market are encapsulated in the debate, both in the past, and in the current legislature of the government and parliament, on both health policy and the redefinition of health rights in the light of the new role some would give the Italian National Health Service (INHS). The purpose of this contribution takes into consideration indicators of health policy at national level, the main strategies with regard to the principles of NHS as well as analysis of the new equilibrium between the State and the market in health. It concerns the role of government and the private sector, their aims of providing better ways of health care, in order to address the issues of the effect of market thinking and its impact on equitable access to health care, system efficiency, outcome for both individual and population, and on the doctor-patient relationship. First, the paper analyses a brief recent history and description of the Italian health care system and the key role of regions in health policy. Second, we examine the INHS principles and the changes in National Health Planning in recent years; what we would like to do here is consider whether they are market-oriented or not. Third, after the analysis of the essential levels of health care as basic health needs within an universalistic model, we look at some empirical evidence concerning services like primary health care, specialist treatments, hospital care etc., and focus on the opinions expressed by Italian people on their satisfaction with the Italian National Health Service. This has implications not just on health financing, but also on preference for a public or a private system. In this way, we try to examine the impact of market thinking and its practice in Italy on the equity and efficiency of the INHS.