The Italian National Health Service was established in the Seventies to put an end to the previous system based on mutual insurance under which people belonging to different professional categories had different health rights.
Despite its name, the National Health Service is not very national since it is largely managed by the Regional Governments under the general supervision of the Ministry of Health.
The result is a health system which is excellent in some Regions, even attracting foreign patients, while in other territorial subdivisions it is lacking at best. Expenditures vary greatly, too.
Should the National Health Service be put under the direct management of the State? Centralization does not seem a solution, especially in a bureaucratically inefficient country like Italy. A preferable option would be the application of the “differentiated regionalism” doctrine, under which efficient Regions should get more financing and more powers, while unfit ones should get less.