According to an analytical report released by the GIMBE Foundation using OECD Health Statistics updated to July 2026, the Italian public health system is suffering from a funding gap of over €36 billion compared to the European average, leaving millions of citizens stranded behind out-of-control waiting lists and collapsing emergency departments.
The Shrinking Budget and the G7’s Widening Chasm
The numbers paint a stark picture of a public health infrastructure slowly starved of necessary capital. In 2025, Italy’s public health spending sits at 6.2% of GDP, slipping downward from 6.3% in 2024. This figure leaves Rome trailing far behind the wider Organization for Economic Cooperation and Development (OECD) average and the European average, both of which stand firmly at 7.1%.
When evaluated on a per-capita basis adjusted for purchasing power parity (PPP), the disparity sharpens into clear focus. Italy allocates $3,952 per person for public healthcare. That leaves the nation $909 behind the OECD average of $4,861 and $1,013 behind the broader European average of $4,965. Among European OECD countries, 14 nations outspend Italy, with Germany at $8,726 per capita. Even nations like Spain, which invests $3,999 per capita, edge ahead of Rome’s public allocation, leaving only some Eastern and Southern European states behind Italy’s footprint.
“The public underfunding of healthcare is no longer a technical accounting issue for insiders, but a structural criticality that has weakened the National Health Service and compromised the enforcement of a fundamental right,” said Nino Cartabellotta, President of the GIMBE Foundation. Cartabellotta noted that the chronic shortfall continuously fuels political friction while trapping regional governments between the legal obligation to guarantee essential assistance levels and the demand to keep the accounts in order.
Human Toll: The Rise of Private Care and Medical Poverty
While macro-economists debate fiscal percentages in Rome, patients across the Italian peninsula bear the brunt of the systemic decay. The GIMBE Foundation analysis highlights that systemic underfunding directly translates to crippled emergency rooms, an acute shortage of family doctors, and widening territorial and social inequalities.
Driven by frustration and months-long diagnostic queues, millions of Italians are forced to turn to private healthcare providers out of pocket. This growing reliance on private outlays has triggered a wave of household impoverishment and debt. According to findings, the financial strain forced 5.8 million people—roughly one in ten—to skip necessary diagnostic exams and specialist medical visits in 2024.
Until 2011, Italy’s per-capita public health expenditure was substantially aligned with the European average. However, the gap progressively widened due to cuts and underfunding. The gap grew further during the pandemic, as other countries invested much more than Italy.
The Road to the 2027 Budget Law
The GIMBE Foundation’s data release is designed to offer objective elements to the political comparison and public debate, stripping the theme of instrumental readings.
How can European nations with comparable economic footprints successfully sustain universal healthcare models while Italy falls further behind? Share your perspective in the comments below.
