The OECD has published the new report “Health at a Glance 2025” and the Italian data are not all good. In fact, despite one of the highest life expectancies in the world, Italy spends on average less on healthcare than other OECD countries: 5,164 dollars per inhabitant, compared to an average of 5,967 dollars. It is also flawed in terms of the number of beds, just 3 per 1,000 inhabitants, compared to the average of 4.2.
The snapshot of the report also places us among the countries with some rather worrying structural problems, such as the serious shortage of nurses and doctors and the high average age.
Italian healthcare spending
Despite what was stated by the Minister of Health, Orazio Schillaci, the Government continues to allocate too few funds to healthcare. Even if the data is increasing, as the opposition points out, the problem is another: investment is growing less than spending.
The difference is starting to be felt, considering that citizens’ spending on private healthcare has increased. Between 2023 and 2024 this reached +4%, reaching 48 billion per year (including insurance). Private healthcare has therefore doubled its revenues, going from 3.1 billion in 2016 to 7.2 billion in 2023, equal to +137%. Of course, the decline in public investment in relation to GDP began in 2014, not with this Government, but in the meantime the population’s health needs have changed and spending is not adapting.
Apart from the two-year pandemic period 2020-2021, when spending was increased substantially, today the increasingly elderly population is not adequately supported by the healthcare system and, in turn, all other age groups are affected. The cracks now announce a possible collapse of the system.
Comparison with OECD countries
The OECD adds a further piece to the analysis, namely the comparison with the 38 industrialized countries and their healthcare systems. In 2024, Italian healthcare spending was equal to 8.4% of GDP, compared to 9.3% of the OECD average.
The highest values are recorded in:
- Germany with 12.7% of GDP;
- France with 10.8% of GDP;
- United Kingdom with 9.3% of GDP.
Even looking at per capita spending levels at purchasing power parity, Italy is lower than the OECD average.
| Village | Spending per capita |
|---|---|
| Italy | $5,164 |
| France | $7,367 |
| Germany | $9,365 |
| OECD average | $5,967 |
The results of Italian public health
Even with limited spending lower than the OECD average, Italy still manages to achieve good results, classifying itself as one of the first-rate healthcare systems.
Life expectancy at birth is 83.5 years, a full 2.4 years higher than average. In fact, we are the fifth country in the world in terms of life expectancy, after Switzerland, Japan, Spain and Israel. Avoidable mortality is also low, with 93 preventable deaths per 100,000 inhabitants, compared to an average of 145.
Fine, but only if you don’t look inside the system. In reality, strong imbalances and warning signs for the future are emerging. While Italy has 5.4 doctors per 1,000 inhabitants (higher than the OECD average of 3.9), a serious shortage of nurses is confirmed, with just 6.9 professionals per 1,000 inhabitants, compared to an OECD average of 9.2.
It is a gap defined by the study as “historical”, because it directly affects the quality of care and the ability of hospital departments and local services to respond to the growing demand for care.
Finally, there is the aspect of beds, which after the two-year pandemic have been reduced again: in Italy there are 3 per 1,000 inhabitants, less than the OECD average (4.2) and much lower than France (5.4) and Germany (7.7).
