Watchdogs say the lack of resources is endangering the health of the nation, with some 4.3 million Italians believed to be at risk. give up treatment due to waiting lists (these can last up to 715 days in case of ultrasound appointment). Elly Schlein, head of the center-left Democratic Party, told POLITICO the government had broken its promises, condemning “dangerous disinvestment” in public health care and “creeping privatization.”

“The welfare state is in great crisis,” said Pierino Di Silverio, a Naples-based surgeon and national secretary of the Anaao medical union. “It is a pillar of our social model – and it is gradually being defunded.”

It is certain that the initial aspiration of the Italian National Health Fund – to provide universal coverage, financed by general taxation – is struggling to survive. The rapid aging of Italy’s population (nearly a quarter of Italians are over 64) means that demand for services is growing much faster than the tax revenue needed to finance them.

In this context, the share of services provided by the private sector has increased steadily over the past decade and now accounts for around a quarter of all health spending in the country. But the growth of a parallel private system has inevitably withdrawn resources – including key personnel – from the public sector. Public system workers are leaving, either to the private sector or abroad, at a rate of 14 per day, Di Silverio said.

This compounds historic problems with the unequal distribution of funding across the country, which has tended to deepen divisions between the rich north and poor south.

The problem is particularly serious, Di Silverio said, in emergency departments, which now have up to 100 patients per doctor. The system is “so underfunded and poorly equipped that people spend entire days in emergency rooms,” recalls a doctor at a large hospital in northern Rome, speaking on condition of anonymity because she was not authorized to speak to the press. While patients are often confined to a simple chair, the staffer said, frustrated relatives often attack overworked doctors, leading to more staff departures and increasingly dire conditions. “Nobody wants to do emergency medicine,” she said.