In regards to fees: I have heard people in some areas getting away that cheaply. Some consulates will even translate documents for free. I had a particularly large number of documents to file, so it got messy for me.

SSN: You are correct that you indeed do not have access to the Italian Healthcare system while living in the US, UK et cetera. But this is completely normal and expected. However on the positive end being a Citizen of the republic means that you are entitled to healthcare in Italy if you wish to take advantage of it. This means that it is a safety net. I am extremely familiar with this because both of my parents have being declared preexisting for forms of cancer. In the event they develop terminal cancer they will NOT be covered by our private insurance and can expect to pay out of pocket 10s to 100s of thousands of dollars. My father is an Irish citizen and my mother is Italian, we rely on our European passports to protect us in the event of terminal illness if we decide to seek treatment in the EU. The Italian Healthcare system (Servizio Sanitario Nazionale) will never deny you treatment, and you will not be expected to pay an unreasonable fee. We had a family member who decided to undergo an expensive operation in Italy because the cost of her treatment would have eaten up any inheritance her family would have received. 

Loss of Citizenship: Yes, you can lose your Italian citizenship under certain circumstances. However naturalisation in most countries is no longer a condition for loss of citizenship as it once was. Italy has a very favourable citizenship law which is designed in favour the nearly 1.5 million Italian citizens living abroad…like me. Furthermore most people will not be naturalising a second citizenship, they will be “recognising”. For example if you are following the process I set out, you are not naturalising. You have in fact ALWAYS been an Italian citizen. Which is NOT a condition for loss of citizenship.

Taxes: There are very few countries which require citizens to even file for taxes in countries they do not reside in. The US is one of the very few. In the US you are required to file an income tax statement even if you do not live there, however you are not required to pay additional tax over what you pay to the country you live in. This is designed to prevent rich Americans from moving their income to tax-havens and avoid taxation. Italy on the other hand does not require you to file income tax statements while living abroad. This means if you decide to live in Europe, you will still be required to file an income tax statement, but because of higher European tax rates you will not be expected to pay twice.

Conflict of Representation: This issue is actually discussed in all US passports. The current ruling is that the US or your first nationality has no jurisdiction over you while you are in a nation where you hold citizenship. For example, if you get into trouble in Italy. You are entirely an Italian citizen and the US has no recourse. If you get in trouble in Russia, you remain a citizen of both countries. You will have access to consular services from both countries, and have the right to ask either or both for consular assistance. This is commonly listed as a benefit of multiple citizenships and is the primary reason why I always keep both passports on me while travelling. Especially in places which have unfavourable relationships with the US (I.e. Cuba).

I understand your feelings. Many people especially Argentines and Brazilians acquire Italian citizenship purely for employment reasons. Which although is a valuable asset to them I can see can be frustrating for you as a born and raised Italian. On the other hand being someone who was raised on the Italian-American hyphen, I understand the real reasons why people apply for Dual Nationality. It is not for employment but rather to embrace where they come from or for many people, to go to school or buy a second home in Italy without legal complication. You said the term “because they think it is cool”. I was a bit hurt by this because, yes, I think my Italian passport is very “cool” I also think it represents everything my family has gone through in their journey from Italy here.

But I agree with you, no one should acquire nationality without having some Italian identity. But I think anyone willing to go through the hassle of getting their documents in order and acquiring a second nationality has more in mind than just “being cool”. In fact I hear all of these reasons against getting dual nationality in the states from people who have the same feelings about citizenship. However I have never heard a single person with dual Nationality complain about any of the things you have mentioned. As a matter of fact I only hear people asking me “do you think you can help me apply for mine?” and “my grandfather will be so proud that I’m an Italian citizen too”.