Healthcare: the budget gives over-75s €300 to spend only outside the public service. Families already pay €42.4 billion out of their own pockets

3 November 2026, 16:13

Public hospitals have been short of doctors and appointment slots for years, and the budget bill for 2027 has taken note with a proposal for the elderly: get treated by someone else, with the State's money. Article 53 of the bill creates a card worth €300, for 2027 only, for those who will have turned seventy-five by the end of 2026 and in 2025 received pensions of no more than €28,000 gross. The technical report estimates about 5.5 million beneficiaries and puts €1.6 billion on the table. As the Prime Minister made clear, the card will be usable only for expenses the public service does not cover; which ones will be set by a decree, and the government has in mind medicines, specialist visits and dental care. The money is public; whoever collects it, by the law's own choice, is not.

To the national health service the same budget allocates, for the year of the card, €2.4 billion in new resources, less than half of what the government had announced at its press conference. For every three extra euros given to public healthcare, then, it puts about two into paying for care outside it. To get the card, moreover, only the pension counts, not household income or wealth: it goes even to someone who, with a pension below the threshold, owns houses that are let out.

That paying for care out of one's own pocket is already the rule, the figures have been saying for some time. In 2025, according to the Gimbe Foundation report presented to the Chamber of Deputies in October, Italian families paid €42.4 billion directly for their health, more than a fifth of all the country's health spending. In 2024 almost six million people gave up at least one visit or test, about four million of them because of waiting lists. The card does not shorten those queues by a single day: it helps pay those who let people jump them.

And it does little. According to Istat, in 2025 a person aged at least sixty-five living alone spent on average €104 a month on care, between medicines, visits and tests: the card does not cover even three months, and for the rest of the year one goes back to paying for oneself. The Gimbe Foundation, meanwhile, calculates that in 2027 the health fund will be €7.6 billion short of expected spending. For the card, on the other hand, the money was found.

In 2027 the pensioner on the list for an appointment will receive three hundred euros to go private, and their booking in the public system will stay where it was.

This article was prompted by a news item published in il Fatto Quotidiano on 1 November 2026.