Health and Healthcare Policy in Italy Since 1861 : A Comparative Approach

Providing a historical overview of healthcare in Italy from its unification in 1861 to the present COVID-19 pandemic, this book analyses the political, social and cultural impact of Italian healthcare policy and medicine. The author examines the development of public health, hospitals, and primary care, and the building of healthcare systems across three political regimes in Italy: the liberal period (1861-1914), Fascism (1922-43), and the Italian Republic (1948 to the present day). By emphasising the embeddedness of health-related legislation in Italy's political and social background, this book offers a comparative account of Italian health policy, and contrasts this with developments in neighbouring European countries, Canada and the United States. The book focuses on the Italian government's reaction to the social and political impact of several diseases: pellagra; cholera; malaria; and tuberculosis, and explores the present-day response to the current COVID-19 pandemic. A timely and comprehensive read, this book will appeal to those teaching and researching Italian history and the history of medicine and healthcare more widely. Francesco Taroni is Professor of legal and social medicine at the University of Bologna in Italy. Previously, he has held managerial positions at a national and regional level. Internationally, he is Visiting Research Scientist at the Sidney Kimmel Medical College's Asano-Gonnella Center for Research in Medical Education and Health Care, Thomas Jefferson University, Philadelphia, USA, and has consulted for the World Health Organization (WHO) and the Organisation for Economic Cooperation and Development (OECD). Francesco has published extensively on healthcare research and his most recent books include Politiche Sanitarie in Italia (Health Policies in Italy, 2011) and Il Volo del Calabrone: 40 Anni di Servizio Sanitario Nazionale (The Flight of the Bumblebee: 40 years of National Health Service, 2019) Preface Contents Abbreviations List of Figures List of Tables Chapter 1: Health in the Making of a Nation The Health of the Population The Piedmontization of the Health Legislation The Long Path to the Sanitary Code The Law of Public Health Secularizing Opere Pie Implementing Crispi’s Laws The Giolittian Era: Reformism Without Reform? References Chapter 2: Health and Healthcare in the Liberal State Cholera, the Nineteenth-Century Disease The Rise and Demise of Pellagra: A Success Story Malaria and Quinine: The First Magic Bullet Doctors, Medical Care, and Work Safety The Rise of the Italian Hospital: Change Without Reform References Chapter 3: The Great War and the Spanish Flu A Public Health Disaster The Medicalization of War The Militarization of Psychiatry Disabled Soldiers and Social Reform Influenza Epidemic and the War References Chapter 4: Health Under the Fascist State The Ascension Day Address: A Political and Ideological Agenda Bonifica Integrale: Land Reclamation and Anti-malarial Policy The Institutional Pillar: Carta del Lavoro and Casse Mutue A World Apart: The Battle Against Tuberculosis The Fragmented Fascist Healthcare State and Its Doctors References Chapter 5: Postwar: Roads Not Taken A Country in Ruins Health and the War A Lukewarm Transition The Beveridge Report in Italy The Constitutional Debate The Rationalist Illusion: D’Aragona Commission References Chapter 6: The Rise and Fall of the Mutual Jungle A New Old Policy The Ministry of “salvo” The Dynamics of Spending and Service Provision Hospitals: Insufficient, Inadequate, and Unprepared A Legitimacy Crisis The Reformist Mirage References Chapter 7: The Creation of the Servizio Sanitario Nazionale The Collapse of the Sickness Funds The Regions, Laboratories of Democracy The Season of the Movements Passing the Law Bugs and Holes of the Reform A Reform Out of Time The Undoing of the Reform References Chapter 8: Reinventing the SSN? The Origins of the “reform of the 1978 reform” The Content: An Assemblage A Swift Process Implementation and Its Impact “Rational rationing” of Drug Benefits Back to Base: The 1999 Reform of the 1992 Counter-reform A Turbulent Process References Chapter 9: New Issues at the Dawn of the Twenty-first Century The First Two Decades of the HIV/AIDS Epidemic From the Politics of Access to the Policy of Excess Responding to Public Expectations: Citizens’ Views References Chapter 10: A Lost Decade Regionalization, Alleged and Real Contractual Relations: Patti per la Salute and Piani di Rientro References Chapter 11: Two Converging Crises Weathering the Great Recession The Second Storm: The COVID-19 Pandemic References Chapter 12: Postscript Regime Types and Health Policies and Institutions Ruptures and Continuities The Role of Organized Medicine Population Health Global Health and National Histories Index