Healthcare Expenditure. A Comparative Analysis

This contribution presents a comparative analysis of healthcare expenditure and the financing of the Italian National Health Service (Servizio Sanitario Nazionale, SSN), comparing it with selected European and non-European healthcare systems. The analysis focuses on the levels and trends of total, public, and private healthcare expenditure, as well as on funding sources and the configuration of the public-private mix, with the aim of identifying the main strengths and weaknesses of the Italian system from a comparative perspective. Particular attention is devoted to the increasing role of private expenditure, the evolving balance between public and private provision of healthcare services, and the associated implications for equity, accessibility, and the long-term sustainability of the SSN. The countries selected for comparison include France, Germany, Spain, the United Kingdom, and Japan, chosen on the basis of their demographic, territorial, and institutional comparability with Italy. The United States is also included, not as a directly comparable case, but as a benchmark representing a healthcare model predominantly based on private insurance and thus structurally distinct from the other systems considered.