The paper analyzes the financial sustainability of Italian health care expenditure within the public finance measures set in 2011. Despite the situation with regard to rest of public administration, the health care sector is in a better position to face the crises because, since 2005, the central budget discipline, which was imposed, stabilized its real growth to zero. The first part of the paper describes how health savings still continue to have a considerable weight on public budget constraint. In the second part, the authors critically discuss the choice of adding an entry ticket to the copayment mechanism whit regard to specialistic outpatient services. The simulated economic effects provide evidence of an anticipated shift of medical care demand towards the private market. The authors argue that the universal health system could be threatened with a progressive escape of the middle class from public health care. They conclude by remarking that the challenges of financial sustainability should be faced through a greater integration of health and social care services, and a stronger convergence policy in terms of regional health care systems as recommended in fiscal federalism reform.

Il sistema sanitario alla ricerca della sostenibilità

CARUSO, Enza;
2012

Abstract

The paper analyzes the financial sustainability of Italian health care expenditure within the public finance measures set in 2011. Despite the situation with regard to rest of public administration, the health care sector is in a better position to face the crises because, since 2005, the central budget discipline, which was imposed, stabilized its real growth to zero. The first part of the paper describes how health savings still continue to have a considerable weight on public budget constraint. In the second part, the authors critically discuss the choice of adding an entry ticket to the copayment mechanism whit regard to specialistic outpatient services. The simulated economic effects provide evidence of an anticipated shift of medical care demand towards the private market. The authors argue that the universal health system could be threatened with a progressive escape of the middle class from public health care. They conclude by remarking that the challenges of financial sustainability should be faced through a greater integration of health and social care services, and a stronger convergence policy in terms of regional health care systems as recommended in fiscal federalism reform.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11391/917033
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