Andrea Innocenti Over the past five years, the National Health Service has suffered a subtle reduction, estimated at €22,7 billion . This decline is the result of a progressive weakening of the National Health Fund (FSN) relative to gross domestic product ( GDP ). This assessment was presented during the budget hearing before the joint Budget Committees of the Chamber of Deputies and the Senate.
Fund absolute growth and relative decline to GDP
From 2022 to 2027, the FSN increased from €125,4 billion to €146,3 billion, a nominal increase of €20,9 billion. However, the fund's ratio to GDP fell from 6,27% in 2022 to 6,14% in 2026 and, according to forecasts, to 6,11% in 2027.
As Nino Cartabellotta, president of the Gimbe Foundation, observes, “ small decimals which, added together, are almost a percentage point of GDP .”
Detail of percentages from 2022 to 2027
In 2022, the FSN covered 6,27% of the country's wealth. This figure decreased by 0,13 percentage points by 2026 and, at current trends, will decrease by a further 0,03 points by 2027.
The cumulative effect of these micro-adjustments translates into a loss of purchasing power of approximately 22,7 billion euros , if the ratio had remained unchanged at 2022 levels.
Impact on regional budgets and political choices
Regional administrations have felt the pressure of these invisible cuts. In 2025, regional budgets show a deficit of €2,3 billion, almost €800 million more than in 2024. Faced with this deficit, political choices boil down to two options: reduce the range of services or impose additional taxes on citizens . Cartabellotta emphasizes that, in both cases, " the citizens pay ."
Family health care spending and forgoing treatment
In 2025, families spent €42,4 billion on healthcare. Although spending growth appears to be stabilizing, this is not due to increased public coverage, but to the growing number of people who can no longer afford healthcare costs . Currently, 5,6 million Italians forgo treatments, tests, or medical visits, a figure that reflects the real impact of invisible cuts on daily life.
The proposals of the Gimbe Foundation
Faced with this scenario, Gimbe has put forward some concrete requests. A priority is the full allocation of the voucher for the elderly to the health fund , as those over 65 require ongoing support more than a one-off bonus. The foundation also highlights the need to review the funding structure to ensure that the fund's nominal growth translates into a stable or increasing share of GDP, thus avoiding further invisible shortfalls.