Health Legislation and the Medical Profession in Italy: 1859-1978

Covering an extended historical periodization, this essay examines Italian healthcare politics, comparing them to the increasing influence of medical doctors and their ability to influence the legislature in decision making. The key element to emerge from this study is the substantial continuity of objectives from the period of the construction of the Italian State up to the 1970s. In that phase, public health is to be understood predominantly as ‘health policing’, that is to say as a branch of the power the executive held over society (epidemics, degenerative illnesses, care for the poor). The increased demand for healthcare from private individuals, in most cases based on insurances, alongside the ability of the medical body to create an identity for itself as the country’s critical conscience in terms of sanitation and the spread of disease, progressively widened the responsibilities of public healthcare, thus complicating issues of its organization and management. The 1978 reform, not without its own quandaries, marks a moment of discontinuity with the previous model, surpassing the limitations of healthcare policing, widening the concept of health and freeing treatment from provident insurances by financing it through general taxation.