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Federalism, Party Competition and Budget Outcome: Empirical Findings on Regional Health Expenditure in Italy

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Author Info
Giardina, Emilio
Cavalieri, Marina
Guccio, Calogero
Mazza, Isidoro
Abstract

In the last decade, Italy has experienced a considerable decentralization of functions to the regions. This transformation has been especially relevant for the National Health System that has de facto assumed a federal system design. The federal reform aimed at disciplining public health expenditure, which drains a substantial share of the budget of Italian regions and is among the main causes of the regional deficits. Political economic analysis, however, suggests that impact of federalism on public expenditure depends on central and local government strategies to win in the electoral competition. Results derived in this preliminary study indicate that political competition actually works as a tool of fiscal discipline; it shows a restraining effect on public health expenditure.

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File URL: http://mpra.ub.uni-muenchen.de/16437/
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Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 16437.

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Date of creation: 2009
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Handle: RePEc:pra:mprapa:16437

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Related research
Keywords: Fiscal federalism; local budget; multi-level policy-making; public expenditure; political competition; health economics;

Find related papers by JEL classification:
H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
H72 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Budget and Expenditures
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
D78 - Microeconomics - - Analysis of Collective Decision-Making - - - Positive Analysis of Policy-Making and Implementation
D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Models of Political Processes: Rent-seeking, Elections, Legislatures, and Voting Behavior

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  1. David Cantarero, 2005. "Decentralization and health care expenditure: the Spanish case," Applied Economics Letters, Taylor and Francis Journals, vol. 12(15), pages 963-966, December. [Downloadable!] (restricted)
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    Other versions:
  3. Besley, Timothy & Coate, Stephen, 2003. "Centralized versus decentralized provision of local public goods: a political economy approach," Journal of Public Economics, Elsevier, vol. 87(12), pages 2611-2637, December. [Downloadable!] (restricted)
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    Other versions:
  5. Joan Costa-Font & Francesco Moscone, 2008. "The impact of decentralization and inter-territorial interactions on Spanish health expenditure," Empirical Economics, Springer, vol. 34(1), pages 167-184, February. [Downloadable!] (restricted)
  6. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health-care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S187-S202. [Downloadable!]
  7. Albert Sole-Olle & Pilar Sorribas-Navarro, 2008. "Does partisan alignment affect the electoral reward of intergovernmental transfers?," Working Papers in Economics 206, Universitat de Barcelona. Espai de Recerca en Economia. [Downloadable!]
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  10. Guillem López-Casasnovas & Marc Saez, 2007. "A multilevel analysis on the determinants of regional health care expenditure: a note," The European Journal of Health Economics, Springer, vol. 8(1), pages 59-65, March. [Downloadable!] (restricted)
  11. Albert Solé-Ollé, 2006. "The effects of party competition on budget outcomes: Empirical evidence from local governments in Spain," Public Choice, Springer, vol. 126(1), pages 145-176, January. [Downloadable!] (restricted)
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  12. Albert Solé-Ollé & Pilar Sorribas-Navarro, 2008. "Does partisan alignment affect the electoral reward of intergovernmental transfers?," Working Papers 2008/2, Institut d'Economia de Barcelona (IEB). [Downloadable!]
  13. Weingast, Barry R & Shepsle, Kenneth A & Johnsen, Christopher, 1981. "The Political Economy of Benefits and Costs: A Neoclassical Approach to Distributive Politics," Journal of Political Economy, University of Chicago Press, vol. 89(4), pages 642-64, August. [Downloadable!] (restricted)
  14. Levaggi, Rosella & Zanola, Roberto, 2003. "Flypaper Effect and Sluggishness: Evidence from Regional Health Expenditure in Italy," International Tax and Public Finance, Springer, vol. 10(5), pages 535-47, September. [Downloadable!] (restricted)
    Other versions:
  15. Giannoni, Margherita & Hitiris, Theodore, 2002. "The Regional Impact of Health Care Expenditure: The Case of Italy," Applied Economics, Taylor and Francis Journals, vol. 34(14), pages 1829-36, September. [Downloadable!] (restricted)
  16. Bordignon, Massimo & Turati, Gilberto, 2009. "Bailing out expectations and public health expenditure," Journal of Health Economics, Elsevier, vol. 28(2), pages 305-321, March. [Downloadable!] (restricted)
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  18. Albert Solé-Ollé & Pilar Sorribas-Navarro, 2008. "Does Partisan Alignment Affect the Electoral Reward of Intergovernmental Transfers?," CESifo Working Paper Series CESifo Working Paper No. , CESifo Group Munich. [Downloadable!]
  19. Becker, Gary S, 1983. "A Theory of Competition among Pressure Groups for Political Influence," The Quarterly Journal of Economics, MIT Press, vol. 98(3), pages 371-400, August. [Downloadable!] (restricted)
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