The Italian state runs a universal public healthcare system since 1978. However, healthcare is provided to all citizens and residents by a mixed public-private system. The public part is the ''Servizio Sanitario Nazionale'', which is organised under the Ministry of Health and administered on a devolved regional basis. Healthcare spending in Italy accounted for 9.2% of the national GDP in 2012, close to the OECD countries' average of 9.3%. Italy in 2000 ranked as having the world's 2nd best healthcare system, and the world's 2nd best healthcare performance.