The financial unsustainability of the Italian public health care system

Purpose of the paper: Health and sustainability have become an almost indissoluble unity of analysis in all advanced health care systems. We ask the research question if the Italian enduring recession will affect the economic and financial sustainability of Government health financing in the period 2014-2018. Methodology: We have adapted the theoretical framework of economic and financial health care sustainability introduced by the WHO in 2009 to an economy suffering from an enduring recession and stagflation, with data obtained from the Italian Document of Economy and Finance 2011 and 2014 and the International Monetary Fund. Findings: We found that the Document of Economy and Finance 2014: 1) has significantly reduced the fraction of GDP allocated to public health financing (6.98%; 95% CI 6.80-7.21) with respect to the previous Document of Economy and Finance 2011 (6.98%; 95% CI 6.80-7.21) at a confidence level of p < 0.05 with t = 4.4285, df = 11.978 and p-value = 0.0008269; 2) has increased the fraction of GDP allocated to non-health financing; 3) has based its spending forecasts on a growing GDP , contrary to all forecasts made by the IMF. Within the analytical framework utilized, this implies that the Italian Government health financing is both economically and financially unsustainable. Research limitations: This approach encounters some limits as the dynamic uncertainty of a socioeconomic downturn and an aging population could induce a complete modification of health care financing from public to a mixture of public and insured private.