[Italy: a national health service with a tumultuous history]

During the 70's, various political forces succeeded to combine their efforts and launched a health reform. The system based on sickness insurance funds each serving a specific social or occupational group was replaced by a universal system covering all the citizens. During the 80's, the reformist context disappeared, the basic units of the new system (U.S.L.) became extremely politicized, resources subsidized by the State became scarce, the people frustrated. At the beginning of the 90's, a new reform was launched, aimed at raising the management level of the USL (ambulatory care) and the large hospitals. At the same time, more financial and managerial responsibilities were transferred to the regions. During these decades, the Italian reform attempted to implement several foreign models. But a long time was wasted in debates and discussions. When the implementation started, these models became outdated and the authors inspiring the reform disappeared themselves from the stage.