A national health plan, begun in 1980, seeks to provide free health care for all citizens, but certain minimum charges remain. It is financed by contributions from salaries, by employers, and by the central government. Patients are still able to choose their own health care providers. Reform implementation in the 1980s and 1990s has been difficult. In 1994, the government announced plans to dismantle public universal insurance. Reforms in 1999 sought to integrate primary care with other health care programs, including home care, social services, and health education. Consistent health reforms are hampered by frequent political changes in administration. Most private hospitals have contracts with the national plan, but health care services are more highly concentrated in the northern regions of Italy. The shortage of medical personnel and hospital facilities in Italy's rural areas remains serious. Closure of a number of underutilized hospitals was planned and the government has been making efforts to curb the state deficit in health expenditures; budgets and estimates are repeatedly more than demand. Health care expenditures as of 1999 were 8.2% of GDP.
As of 1999, there were an estimated 5.9 physicians and 5.5 hospital beds per 1,000 people. In the same year, Italy had 842 public hospitals and 539 private ones, for a total of approximately 276,000 beds.
The infant mortality rate, 72.1 per 1,000 live births in 1948, decreased to 5 per 1,000 by 2000, when average life expectancy was estimated to be 79 years. As of 2002, birth and death rates were estimated respectively at 8.9 and 10.1 per 1,000 people. In 1994, 78% of married women (ages 15 to 49) were using contraception.
In 1999, immunization rates for children up to one year of age were: diphtheria, pertussis, and tetanus, 95%, and measles, 70%. The major causes of death per 100,000 in 1991 were the following: circulatory system diseases (425.3), cancers (260.6), respiratory diseases (59.6), and accidents and violence (53.2). More men (38% 15 and over) smoked than women (26% 15 and over) in 1994.
As of 1999, the number of people living with HIV/AIDS was estimated at 95,000 and deaths from AIDS that year were estimated at 1,000. HIV prevalence was 0.4 per 100 adults.