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Spesa sanitaria, demografia, governance istituzionale - Tra trend storici e proiezioni a lungo termine

Author

Listed:
  • Fabio Pammolli

    (Politecnico di Milano and CERM Foundation - Competitività, Regole, Mercati)

  • Nicola Carmine Salerno

    (Ufficio parlamentare di bilancio)

Abstract

Nel corso dell'ultimo quindicennio, la spesa sanitaria pubblica ha subito una compressione e una successiva stabilizzazione in termini di PIL ai livelli all'incirca pari a quelli del 1990. Questo processo è stato parte della più ampia risistemazione della finanza pubblica, per favorire la partecipazione alla fase finale dell'introduzione della moneta unica europea. A questo restringimento del canale di finanziamento pubblico si è contrapposto il processo di invecchiamento più incisivo tra i Partner UE, che si è tradotto in un crescente peso del finanziamento privato. Il trasferimento di responsabilità tra pubblico e privato è avvenuto, e ancor tutt'ora avviene, sottoforma di maggiori pagamenti dei cittadini a valere sui loro redditi disponibili, in presenza di uno sviluppo ancora embrionale di forme organizzate e gestite professionalmente di copertura sanitaria (fondi e assicurazioni), e senza il supporto di schemi articolati e organici di agevolazione fiscale e di regolazione della domanda. Se si focalizza l'analisi sugli anni più recenti (2000-2004), emerge chiaramente il riaffiorare di tendenze di crescita delle spesa sanitaria pubblica, riconducibili non a scelte chiare e programmate delle risorse da dedicare al settore, ma ad una vera e propria "deriva" che si sta producendo nel contesto normativo e istituzionale federalista iniziato e ancora gravemente incompleto.

Suggested Citation

  • Fabio Pammolli & Nicola Carmine Salerno, 2006. "Spesa sanitaria, demografia, governance istituzionale - Tra trend storici e proiezioni a lungo termine," Working Papers CERM 02-2006, Competitività, Regole, Mercati (CERM).
    • Handle: RePEc:ern:wpaper:02-2006
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    References listed on IDEAS

    as
    1. Gerdtham, Ulf-G. & Lothgren, Mickael, 2000. "On stationarity and cointegration of international health expenditure and GDP," Journal of Health Economics, Elsevier, vol. 19(4), pages 461-475, July.
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    3. Getzen, Thomas E., 2000. "Health care is an individual necessity and a national luxury: applying multilevel decision models to the analysis of health care expenditures," Journal of Health Economics, Elsevier, vol. 19(2), pages 259-270, March.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    previdenza complementare; TFR;

    JEL classification:

    • D60 - Microeconomics - - Welfare Economics - - - General
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • H30 - Public Economics - - Fiscal Policies and Behavior of Economic Agents - - - General
    • H50 - Public Economics - - National Government Expenditures and Related Policies - - - General
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H70 - Public Economics - - State and Local Government; Intergovernmental Relations - - - General
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • H77 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Intergovernmental Relations; Federalism
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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