This article focuses on the main health reforms enacted in Italy over the past one hundred years. Such reforms were all undertaken in conjunction with a severe political and institutional crisis. The 1943 reform was approved a few weeks before the fall of the Fascist regime. The National Health Service, established by Law No. 833 of 1978 and enacted during one of the most turbulent times in the history of the country, represented the apex of the brief experience of the “national solidarity” governments. Even the 1992–93 reform was put into effect in the midst of the Tangentopoli scandal, which marked the transition from the First Republic to the so-called Second Republic. To attempt an analysis of the main turning points in Italian health care policies, the well-known multiple streams approach is adopted.

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