[Critical issues in the Italian healthcare system: the need of a paradigm shift.]

In our country, the SARS-CoV-2 pandemic has put a strain on the achievements deriving from the establishment of the universal national healthcare system highlighting its critical issues. This article is intended to illustrate firstly how the shortcomings related to the economic, technological and human resources together with the inequalities in access to healthcare services, but also the weak commitment to prepare for and prevent pandemics combined with the issues in caring for frail and chronically ill patients have ended up playing a crucial role. Secondly, the article outlines the recent review process of the Italian healthcare system, triggered by the SARS-CoV-2 pandemic that gave rise to some important improvement proposals which will hopefully lead to the expected outcomes. These include, above all, five key-points: a) the integration between public and clinical health care services; b) the development of economic, social and environmental policies such as Health in all policies and One health; c) the reinforcement both in quality and quantity of the healthcare professionals; d) further spread and development of more advanced technologic supports; e) the development of healthcare plans including the public and private sectors acting in a coordinated relationship, taking duly into account the principle of subsidiarity in view of providing the best service to the community as a whole.