SOMMARIO: 

1. Lo stato attuale del Servizio Sanitario Nazionale italiano. 

2. Nascita ed evoluzione organizzativa del Servizio Sanitario Nazionale: breve excursus storico. 

3. Il fallimento della riforma del 1978 e la (conseguente) scelta del 1992-1999. 

4. Le aziende sanitarie tra pubblico e privato. 

5. La dirigenza sanitaria ed il difficile dosaggio tra politica e tecnica nel governo della
sanità. 

6. La tutela della salute tra Stato, regioni e comuni. 

7. Pubblico e privato nel Servizio Sanitario Nazionale. 

8. Prestazioni sanitarie e vincoli finanziari. 

9. Bilancio dell’esistente e prospettive di ulteriori riforme.

Abstract: 

The research is aimed at identifying the faults of the Italian Health Service (S.S.N.) in the light of recent legislative developments and upcoming reforms. It stems from an analysis of the underlying reasons of the substantial failures of Law No. 833 of 1978, the following reform in 1992-1993 presents several elements of a sharp break with the past legal regime and institutional set up, athough it did not sweeped away the whole pre-existing system. Then, on the one hand, the 1999 reorganisation adopted by the so-called “Bindi Decree” has completed the process started in 1992 and, on the other hand, reintroduced some elemnts of the 1978 Law. Furthermore, the research highlights that the shift from traditional administrative model to that of the current hospital authorities with a company’s form has created more issues than any other privatisation process in Italy. Indeed, in this context, health service agents deal with social rights and entitlements and, most of all, with the protection and promotion of the right to healt being the social right par excellence. Finally, the paper analyses the “variables” which are the grounds for any further reform plan of the national health system and identifies possible legislative proposals which would improve the issues constantly at the crux of any health system reform over the years