[The Italian experience: from a national health system to diversified forms of taking charges of patients]

The Italian health system was reorganized in 1978 on the basis of the British NHS. During the 80's, scarcity of resources, organizational bottlenecks and discontent of the consumers have led to various contemplated reforms in view of a better management of the public sector and an enlarged competition of both sectors, public and private. The article unveils the economic rationale of past and on-going developments and underlines some pre-requisites for implementing the reform launched in 1992-1993.