Policy inaction. L’inerzia delle politiche LTC in Italia e le sue ragioni

Italy’s long-term care (LTC) system has been caracterised by enduring institutional inertia, remaining virtually unchanged since 1990 – a situation without parallel in the European context. Even the Covid-19 pandemic, which prompted reform efforts in LTC systems across other European countries, failed to bring about significant change in Italy. Although the pandemic highlighted the system’s weaknesses and led to the introduction of a legislative reform tied to the National Recovery and Resilience Plan (PNRR), this reform was never implemented. Various explanations have been offered for the persistent inertia in this policy sector. This article contributes to the discussion by examining the most recent LTC system reform and interpreting it as a case of policy inaction. Through this analysis, the article identifies the system’s prolonged stagnation as the outcome of several interconnected factors: the absence of a meaningful public debate, the influence of social stakeholders, competition between ministries, and the lack of strong political incentives to pursue reform.