Health expenditure will remain at a standstill at 6.4 per cent of GDP until 2029, and in the three-year period 2027-2029, compared to forecasts, there will be a shortfall of 30.6 billion needed to guarantee services to citizens. This is the central figure of the Gimbe Foundation’s analysis of the Public Finance Document 2026, approved on 22 April by the Council of Ministers.
The picture shows a growing gap between the estimated needs and the resources already planned for the national health fund. “And in the absence of substantial, but unrealistic investments starting from the next Budget Law,” comments Nino Cartabellotta, president of the Gimbe Foundation, “this imbalance can only be unloaded on the budgets of the Regions, which will be forced to increase tax pressure or cut services.
The Gimbe Foundation has examined the 2025 final health expenditure, the forecasts for 2026 and the estimates for the three-year period 2027-2029, comparing them with the expenditure forecasts and the public funding allocated, taking a snapshot of a public health service that is increasingly under financial pressure.
Financial statement 2025
For the year 2025, the 2026 PFD certifies a health expenditure/GDP ratio of 6.3%, unchanged from 2024, confirming that in relation to the wealth produced by the country, health expenditure remains stable. In absolute terms, in 2025 health expenditure amounts to 141,539 million, an increase of 2.5% compared to 138,335 million in 2024. “The increase of €3,204 million between 2024 and 2025,” Cartabellotta observes, “is significantly lower than last October’s forecasts: in fact, the Public Finance Planning Document, updating the forecasts of the DFP 2025, estimated healthcare spending of €144,021 million, almost €2.5 billion more than the 2025 final figure. This is a clear sign of how unstable healthcare expenditure forecasts are and, above all, they are always downwards’.
forecast 2026
For the year 2026, the PFD estimates a health expenditure/GDP ratio at 6.4%, slightly up from 6.3% in 2025. In absolute terms, the projected healthcare expenditure is 148,522 million, an increase of 6,983 million (+4.9%) over the previous year. “Considering that the last Manoeuvre set the national health fund at 143.1 billion for 2026,” Cartabellotta explained, “the forecast for health spending is unrealistic without increasing regional deficits. That is, as with the 2025 final balance, it is likely that this forecast will subsequently be revised downwards’.
