A Comparison of the Italian and Chinese Health Care Systems: Policy, Convergence, and the Need for Reform

Health systems are fundamental to ensuring the right to health and maintaining the stability of welfare states. In this broad framework, this narrative review takes a look at Italy and China—two countries with very different historical backgrounds and institutional paths—as they deal with challenges like demographic aging, increasing chronic illnesses, and ongoing disparities in access to care. This paper aims to examine the most relevant peer-reviewed studies, as well as current legal and policy documents, in order to outline a comparative overview of the approaches to financing, coverage, and service provision in Italy and China, two very different countries. The Italian National Health Service, financed through general taxation and designed to be universal, aims to ensure equitable access to healthcare while having to contend with significant regional differences and financial difficulties. On the other hand, China, which operates with a mixed model, has rapidly expanded its insurance coverage using a variety of schemes and embracing technological advances, which has enabled large-scale access to healthcare, although considerable differences remain between urban and rural areas and provinces. When compared, each system shows particular strengths: Italy’s local care networks and focus on continuous services offer a model for inclusive welfare, while China’s use of digital tools demonstrates how innovation might help overcome obstacles in settings with limited resources and maintain continuity of care. There is a noticeable overlap in how both countries handle chronic diseases and their shared concern for equity in health policy. Considering these points, mixed approaches that combine universal coverage, financial viability, and flexible use of technology could provide useful ideas for crafting more fair, effective, and resilient health policies in various settings. Rather than proposing direct policy transfer, the comparison identifies context-dependent strategies that may inform future healthcare reforms.