Tutela della salute e regionalismo differenziato. Alle origini di un history case.

The complex relations between central and local governments have always been under the lens of the academic analysis, from both a juridical perspective as well as a political and institutional perspective. The present state of global sanitary emergency, with its deep impact on the delicate balances among the main constitutional bodies, has revived in many countries the center-periphery dichotomy, extremely evident in the decision-making process related to the sanitary containtment’s measures. In Italy, the need of granting the health protection as one of the fundamental principles of the Republican Constitution of 1948, has brought the central government to resort frequently to the Decrees of the President of the Council of Ministers (DPCM). A purely administrative tool adapted to the State of emergency, the DPCM – especially the first ones – represent a form of high discretionary decision-power exercised by the Council of Ministers and, ultimately, by the President of this governmental collegial body. By imposing a series of sanitary measures which impacted primarily on the individual liberty as well as on the right to work and, ultimately, on the entire national economic system, the introduction of DPCM unleashed a heated political debate about the correct distribution of competences between center and periphery – considered, especially that, since the constitutional reform of 2001 all the regional governments enjoy a substantial autonomy in the management of the public health system. Given these premises, the aim of this essay is to show how this bitter partitical confrontation about center-periphery relations in a state of sanitary emergency is nothing but another evidence of both the missed fulfillment of the regionalist project contained in the Italian Constitution, and, consequently, a serious systemic Italian problem in overcoming the centralist model of government.