# Italian National Health Service systemic challenges > Live situation record from CLSTR: https://clstr.news/situations/italian-national-health-service-systemic-challenges > Updated: 2026-10-11T04:00:58.000Z. Sources: 10. Developments: 2. The 9th Gimbe Report on the Italian National Health Service (SSN) highlights systemic challenges regarding funding, accessibility, and regional inequality. The report projects a €32.3 billion funding gap between 2027 and 2029, noting that the SSN has experienced €18.8 billion in ‘invisible cuts’ over the previous four years. Accessibility is increasingly tied to income and geography. In 2024, roughly 5.8 million people reported renouncing medical visits due to economic constraints or long waiting lists. Out-of-pocket spending reached 42.4 billion euros in 2025, while spending at non-accredited private facilities rose by 169% between 2016 and 2024. Regional disparities are significant. Molise presents a paradox where it receives the highest healthcare funding per capita in Italy at €2,319, yet maintains the lowest density of employed doctors at 1.35 physicians per 1,000 inhabitants. Other regions show specific deficiencies in essential levels of assistance: Sicily struggles with prevention, Calabria lacks sufficient district assistance, and the Autonomous Province of Bolzano shows deficiencies in prevention. ## Timeline ### 2026-10-11: GIMBE Report: Italian healthcare access tied to income and location The GIMBE Foundation report highlights growing inequality in Italy's healthcare, with millions renouncing care due to costs and long waits, and regional gaps in prevention and assistance. 4 sources. https://clstr.news/cluster/gimbe-report-italian-healthcare-access-tied-to-income-and-location ### 2026-10-07: Molise faces healthcare paradox with high funding but lowest doctor density The Gimbe Report reveals a crisis in Italy's healthcare system, highlighting Molise's paradox of having the highest per capita funding but the lowest number of doctors per inhabitant. 6 sources. https://clstr.news/cluster/molise-leads-italy-in-healthcare-funding-but-lacks-sufficient-doctors --- Cite as: Italian National Health Service systemic challenges. CLSTR, https://clstr.news/situations/italian-national-health-service-systemic-challenges