NDLI: Fiscal decentralization in the Italian NHS: what happens to interregional redistribution?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ferrario, Caterina Zanardi, Alberto
Spatial Coverage	Italy
Description	Country affiliation: Italy Author Affiliation: Ferrario C ( Department of Economics, Institutions, Territory, University of Ferrara, Italy. caterina.ferrario@unife.it)
Abstract	This paper explores how pressures for an increased decentralization of taxing powers to sub-national governments may affect the degree of income redistribution across regional territories accomplished by the Italian NHS. In Italy, political responsibilities for health care are decentralized to regional governments, but the central government retains a critical role in ensuring all citizens uniform access to health services. To this end the central government runs an expenditure needs equalizing system to top up regional governments own resources. However, this system is currently put under question by strong political pressures calling for a weakening of central government involvement. Applying a well developed econometric approach we find that the NHS currently reduces interregional differences in per-capita income by about 7% of GDP. A reform of the NHS in terms of a reduction of expenditure standards produces a weakening of redistribution across jurisdictions, the size of which crucially depends on the financing arrangements of health care that will be actually adopted. We conclude that the decentralization of the NHS would give rise to relevant policy issues concerning in particular the different health care spending possibilities across regions and the impact on the interregional mobility of patients.
File Format	HTM / HTML
ISSN	01688510
Issue Number	1
Volume Number	100
e-ISSN	18726054
Journal	Health Policy
Language	English
Publisher	Elsevier
Publisher Date	2011-04-01
Publisher Place	Ireland
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Health Care Discipline Health Policy Discipline Health Services Discipline Public Health Models, Econometric National Health Programs Economics Politics State Medicine Efficiency, Organizational Federal Government Health Care Reform Health Expenditures Trends Health Policy Health Services Accessibility Humans Italy Organizational Innovation Social Change Taxes Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Health Policy

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