Italy was ‘patient zero’ of the Western world with regard to the spread of COVID-19. However, COVID-19 had different social, economic and health implications in Italian regions depending on their existing features. These same differences emerged with renewed strength during the pandemic crisis, especially during the second wave, when Italy adopted a regionally differentiated system to react to the spread of the virus in which the regional health system’s features played a crucial role. In many cases, regions have been classified as risky because of the structure of their health system rather than high rates of positive tests or deaths, meaning that in those regions people were less likely to find a free hospital bed and receive the necessary care in case of need. COVID-19 may have highlighted what researchers have been investigating for a long time: is there still ‘one’ right to healthcare or are there instead ‘multiple’ rights with a strong regional dimension? The chapter first analyses the structure of Italian regional health systems to highlight regional differences in terms of organisation and services. Then, data on hospitalisation and health services provision during the last year will be used to show the variety of regional responses to the crisis.
