Il federalismo in sanità: opportunità e rischi tra finanziamento, equità ed assistenza

Abstract

Federalism in Italy arised beginning ’90, pushed bipartisanly from establishment in order to contrast the succesfull poll of northern league party. Being about 80% of the regions budget for healthcare, federalism had its hard impact on it. Regions can manage autonomously their healthcare organization, adding to the State financial resources own money earning from other their services or coming from local taxes, on condition that they provide the State LEA (Essential Level of Assistance). That means a high level of responsabilization for local government for reaching a higher level of efficiency in allocation of resources and organizational models of production and erogation of healthcare, beside a better ability to catch local healthcare demand. Even if now the sharing of State financial resources are agreed between all regions and Government, it’s not clear for the future wheter each region will have to procure its own finance, introducing many problems for those southern regions unable to substain theirselves. It has still to be defined wheter and how reach regions will have to transfer part of their resources to the poor ones. That means a risk of iniquity of level in healthcare provision among regions of the same country, generating possible social conflict. Therefore federalism now has from a hand the opportunity to better tail healthcare on each local demand and, on the other hand, it risks to introduce social disparity and conflicts.