The record number of centenarians tells us a lot about Italian healthcare.

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Good news, when it arrives, is usually hidden in a box on page twenty, because good news, when it arrives, usually has the effect of a punch: it challenges the perceived world, overturns the principle of reality, undermines the agenda of universal catastrophism. In this specific case, the news that struck us yesterday comes from Istat . It doesn't concern the government's maneuver, it doesn't concern politics, but it concerns a fact that should interest anyone who wants to shift, so to speak, their horizon from managing the present to designing the future. Istat, yesterday, confirmed that Italy remains one of the longest-lived countries in the world. And it added even more encouraging news to this good news: with over 23,500 centenarians as of January 1, 2025, the number of people over 100 in Italy has more than doubled since 2009. To be precise, it has increased by 130 percent. Everyone is free to consider this achievement by Italy as a success that occurred despite our healthcare system or even thanks to it.

We, in our own small way, lean toward the second theory, that is, toward the idea that the National Health System, with all its flaws, is a jewel to be preserved, cared for, cherished, and nurtured . The centenarian data should be there to remind us of the importance of having a public opinion educated on the issue of healthcare, not through propaganda, catastrophism, pessimism, or alarmism, but through facts, numbers, data, and perhaps even anti-demagogic campaigns. In other words, the exact opposite of what happens every time a government, of any political persuasion, finds itself battling over healthcare issues. Every year, a majority tries to find a way to strengthen the healthcare system by investing a little more money (in 2026, the National Health Fund will reach €143 billion, in 2027 €144 billion, in 2028 €145 billion: healthcare spending in Italy is 5.9 percent of GDP, the European average is 6.5 percent). And every year, both left and right carefully choose to sideline the only three issues, besides the issue of wages, that could allow healthcare to perform even better. First point: spend better, not necessarily more, which wouldn't be difficult considering that every year Italy wastes €50 billion on unnecessary tests and superfluous drugs. Second point: choose doctors based on expertise, not affiliation, which wouldn't be difficult if politicians chose to distance politics from healthcare. Third point: combat the demagoguery of local politics, which would like hospitals in every corner of the city to please voters, and remember that today 80 percent of hospitalized patients could be treated at home or in local facilities, if only the system were organized to do so, and that therefore the true revolution in healthcare comes not only from billions but above all from rules .

ISTAT data, from a certain perspective, confirms that the anti-demagogy approach is the right one for a healthier Italy. Liguria, Friuli Venezia Giulia, Tuscany, Sardinia, and Molise are among the regions with the highest concentrations of centenarians, and not coincidentally, they are also the regions where community-based medicine has historically been most deeply rooted. And the fact that 91 percent of centenarians live with their families, and not in institutions, suggests that Italian longevity depends not only on medical technology, but also, as ISTAT seems to emphasize, on a combination of family care, community-based medicine, and relational welfare . The future of healthcare, as Professor Giuseppe Remuzzi reminded us months ago, is not just hospital-based, but local and community-based. The National Health System is stronger than we imagine, but to make it even stronger, politicians should start addressing the things they rarely address: merit, organization, depoliticization, and with a little more optimism.

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