The contribution is based on the emergency situation following the Covid-19 pandemic. The dramatic situation that has arisen offers an opportunity to reflect on the characteristics of Italian health care and in particular on the model for the division of responsibilities in health matters between the State and the regions. Every emergency requires exceptional interventions and extraordinary decisions. In a health emergency such as the current one, it is natural to set up task forces, intervene with emergency decrees or act on the contingency way. The basic question is whether the regionalization of health care, as it has been formed since 1992, is the suitable institutional model to respond in a unified and homogeneous way to the health needs of Italians. The paper proposes and argues the hypothesis of bringing hospital care back to the central level. The Regions would be kept in charge of primary care and low and medium-intensity hospitalization. In this way, in front of critical issues the chain of responsibilities and the leadership of the system would be clear.
Keywords: Health care management, governance, institutional healthcare models.