How Does Fiscal Decentralization Affect Within-Regional Disparities in Well-Being? Evidence from Health Inequalities in Italy

27 Pages Posted: 2 Jul 2015

See all articles by Cinzia Di Novi

Cinzia Di Novi

Ca Foscari University of Venice

Massimiliano Piacenza

University of Piemonte Orientale

Silvana Robone

University of York - Centre for Health Economics

Gilberto Turati

Catholic University of the Sacred Heart, Rome

Date Written: June 30, 2015

Abstract

This paper aims at investigating empirically the impact of fiscal decentralization reforms on inequality in well-being. In particular, we look at the effects on health inequalities following the assignment of larger tax power to the Italian Regions for financing their health expenditure, starting from the end of the Nineties. Exploiting large differences in the size of the tax base across Regions, we find that fiscal decentralization processes that attribute a greater tax power to lower government tiers, besides reducing inefficiencies of healthcare policies, seem to be effective in reducing also within-regional disparities in health outcomes. However, the degree of economic development – on which depends the actual fiscal autonomy from Central government – significantly affects the effectiveness of these reforms and highlights the importance to take properly into account the specific features of the context where the decentralization of power is implemented.

Keywords: Fiscal decentralization, regional governments, healthcare policy, health inequalities.

JEL Classification: H75, I14, I18, R50

Suggested Citation

Di Novi, Cinzia and Piacenza, Massimiliano and Robone, Silvana and Turati, Gilberto, How Does Fiscal Decentralization Affect Within-Regional Disparities in Well-Being? Evidence from Health Inequalities in Italy (June 30, 2015). University Ca' Foscari of Venice, Dept. of Economics Research Paper Series No. 21/WP/2015, Available at SSRN: https://ssrn.com/abstract=2625503 or http://dx.doi.org/10.2139/ssrn.2625503

Cinzia Di Novi

Ca Foscari University of Venice ( email )

Dorsoduro 3246
Venezia, 30123
Italy

Massimiliano Piacenza

University of Piemonte Orientale ( email )

DIGSPES
Palazzo Borsalino, Via Cavour 84
Alessandria, AL 15121
Italy

HOME PAGE: http://https://upobook.uniupo.it/massimiliano.piacenza

Silvana Robone (Contact Author)

University of York - Centre for Health Economics ( email )

York YO10 5DD
United Kingdom
0044 1904 321452 (Phone)

Gilberto Turati

Catholic University of the Sacred Heart, Rome ( email )

Largo F. Vito, 1
Rome, 00168
Italy

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