Health Care and its Financing in Italy: Issues and Reform Options

IMF Working Papers, October 1, 2000

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Health Care and its Financing in Italy: Issues and Reform Options

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Bibliographic details

• Authors: Franco Reviglio
• Published: October 1, 2000
• Series: IMF Working Papers
• DOI: https://doi.org/10.5089/9781451858099.001

Summary

• In Italy, health care budget ceilings are not effective.
• The poor control by the central government results in:
  • excessive use of expensive inputs,
  • long waiting lines for medical procedures,
  • the emergence of large arrears to suppliers and commercial banks.
• To fully gain the benefits of its decentralized structure, Italy needs to:
  • clarify the rules of the game and strengthen controls on local health authorities,
  • extend full fiscal responsibility to local governments on both the expenditure and revenue sides.
• The central government should be involved neither in decisions on the services that local governments should supply, nor in their planning and management.

Key Findings

• Budget ceilings at the national level are ineffective in constraining health care spending.
• Weak central-government control contributes directly to inefficiencies and financial strains in the health sector:
  • excessive use of expensive inputs,
  • long waiting lines for medical procedures,
  • large arrears to suppliers and commercial banks.

Policy Recommendations

• Clarify the rules governing the decentralized health system.
• Strengthen controls and oversight of local health authorities.
• Assign full fiscal responsibility to local governments on:
  • the expenditure side,
  • the revenue side.
• Remove central government involvement in:
  • decisions on the specific services local governments should supply,
  • the planning and management of local health services.

Subject and Keywords

• Subject: Arrears, Expenditure, External debt, Health, Health care, Health care spending
• Keywords: accrual expenditure, Arrears, authorities claim, expenditure overrun, expenditure side, expenditure undervaluation, government, government debt-accounting problem, government funding, Health care, Health care spending, health indicator, health program manager, health sector deficit, lack of responsibility, Public health care in Italy, regional authorities, WP

Content in this bundle

• Health Care and Its Financing in Italy: Issues and Reform Options - WP/00/166
  • Health Care and Its Financing in Italy: Issues and Reform Options - WP/00/166 (Markdown version)
  • Health Care and Its Financing in Italy: Issues and Reform Options - WP/00/166 (PDF)