Italy has fallen to last place in the G7 for public health spending as a proportion of GDP, according to a new report, prompting warnings about the future of the country’s national health service.
Public health spending accounted for 6.2% of Italy’s GDP in 2025, down from 6.3% in 2024, according to the latest analysis by the GIMBE medical foundation.
The figure is significantly below the 7.1% average recorded across both the OECD and European countries, according to GIMBE, which says Italy would need to invest an additional €36 billion a year to close the gap with the European average.
GIMBE president Nino Cartabellotta described the underfunding of public healthcare as a structural problem rather than simply an issue of government accounting. He warned that years of insufficient investment had weakened Italy’s National Health Service and made it increasingly difficult for people to access healthcare.
“The price is paid by citizens,” Cartabellotta said, pointing to long waiting lists, pressure on emergency departments, shortages of family doctors and growing regional and social inequalities.
5.8 million Italians skipped healthcare
GIMBE said the consequences were also being felt directly by households. In 2024, 5.8 million people in Italy reportedly gave up specialist consultations or diagnostic tests, with financial difficulties among the reasons cited.
Italy also ranked 15th among the 27 European countries in the OECD area for public health spending per person in 2025. Spending was equivalent to $3,952 per person, around $909 below the OECD average and $1,013 below the average for the European countries included in the comparison.
GIMBE said the gap with other European countries had been widening since 2011. The foundation’s report comes as preparations begin for Italy’s 2027 Budget Law, making healthcare funding likely to become a major political issue in the coming months.
Government says health funding is increasing
The government has rejected the suggestion that it is cutting funding to the health service. Health Undersecretary Marcello Gemmato said the National Health Fund would increase again, arguing that the government had already significantly increased healthcare funding during its time in office.
“Over the last three years there have been €18 billion more,” Gemmato said. He added that there would be a further €6.3 billion increase this year.
The government’s figures refer to the absolute amount allocated to the health fund, while GIMBE’s headline measure compares public health spending with GDP. The two figures therefore measure different aspects of healthcare financing.
GIMBE argues that what matters is whether spending is sufficient to meet the country’s healthcare needs and keep pace with economic growth.
Pressure grows ahead of 2027 Budget
GIMBE is calling on the government and Parliament to address what it describes as a structural funding gap rather than relying on annual increases that fail to close the difference with other European countries.
The foundation also warned that additional funding needs to be accompanied by reforms capable of turning investment into accessible services, particularly by addressing shortages of healthcare staff and regional differences in provision.
With the debate over Italy’s 2027 Budget now getting underway, healthcare is set to be one of the areas where the government’s spending priorities face close scrutiny.
