The seventh GIMBE report analyzes the state of the Italian National Health Service (SSN), highlighting several critical issues that threaten the sustainability of the system. Among the main problems are underfunding, managerial inefficiency, increasing out-of-pocket expenses, and regional disparities in access to care. The report emphasizes the urgency of structural interventions to ensure equitable and quality healthcare, especially in light of the Health Mission of the National Recovery and Resilience Plan (PNRR), which presents various challenges in its implementation.