Italy’s banks are some of the most troubled banks in the Eurozone. Weighed down by bad loans, they may all be once again looking for new sources of capital after burning through cash from prior bailouts. Banca Monte dei Paschi di Siena SpA is the oldest surviving bank in the world, and the third largest bank in Italy, and it has an uncertain future following the recent vote in Italy to reject the government’s economic plan. The bank also has a Weiss safety rating of D-.

Following the vote, a rumored capital injection from foreign sovereign funds for Banca Monte dei Paschi has come into question. Unless Italy is prepared to lose this 500-year-old bank -- and potentially cause a catastrophic collapse of other banks and ripples that could grow to destroy the Eurozone -- it almost certainly will have to be bailed out.

Based on the Weiss global bank ratings, all rated Italian banks receive a rating in the D range. Even UniCredit SpA, the sixth largest Eurozone bank and the largest one in Italy, is currently rated D.

Weiss Rated Italian Banks by Asset Size

Without a bailout, these banks may have a tough time surviving. Normally, one way for banks to raise cash is to sell their non-performing loans to other investors. Due to reduced chances of recovering the money owed, these loans are sold at a discount. But with a systemic loan performance problem, a loan sale option with out-of-country investors has little chance of success. So the banks once again have to turn to the Italian government and the European Central Bank for help. And if this recent vote is any indication, that seems unlikely.

Italy is clearly the real sick man of Europe, with a cold the rest of the Eurozone does not want to catch. And it could also infect the U.S. The United States had over half a trillion dollars ($571 billion) in trade with the European countries through October, 2016. So Italian bank losses could have lasting repercussions for big banks stateside.