[The challenges for the Italian National health system.].

The challenge of the National health system is that of ensuring access to medical treatments of increasingly higher quality to a growing stock of ageing population, with the goal of increasing not only life expectancy but also life expectancy in good health and free from disabilities. The dual (public/private) health system is based on the two pillars of a public sector where access is free or at low cost and a private sector where access to treatment is expensive. The dual system typically produces excess demand of treatment in the public sector with the consequence of creating long queues and waiting lists. The problem was enhanced by the slow-down of ordinary treatments during the Covid-19 pandemics. The consequences of these limits is that income inequality generates inequalities in terms of health and life expectancy. The challenge of fighting inequalities of access and improving quality of health in our country is open. It can be tackled effectively not only with the improvement of NHSs but also working on side factors such as education, income, policies against inequalities, of active ageing and promoting generativity and life sense. These factors can increase the effectiveness of prevention, reduce the need of treatments and improve their effectiveness at the insurgence of new diseases.