The debate on differentiated autonomy involves issues that are crucial to the country’s cohesion. For this path to be truly sustainable, it is essential to clearly define the Essential Levels of Performance (LEP) and the related financing mechanisms. Only in this way can autonomy develop without creating new inequalities.
The healthcare sector deserves particular attention, as this is where the most critical issues emerge. The transfer of additional powers to the regions risks widening existing regional disparities without guaranteeing concrete benefits in terms of efficiency. In this sector, the Essential Levels of Care (LEA) already constitute a benchmark: the real challenge is not their regulatory definition, but the system’s ability to ensure their uniform provision throughout the country.
In this context, the role of the State remains fundamental. Strong central oversight, capable of ensuring territorial balance, political coordination, and adequate monitoring, is essential to prevent a fragmentation of social rights that would be difficult to remedy. Every step toward decentralization must therefore be accompanied by instruments that safeguard the substantive equality of citizens, regardless of the region in which they reside.