Template-Type: ReDIF-Paper 1.0

Author-Name: Cinzia Di Novi 
Author-X-Name-First: Cinzia 
Author-X-Name-Last: Di Novi

Author-Name: Massimiliano Piacenza
Author-X-Name-First: Massimiliano
Author-X-Name-Last: Piacenza


Author-Name: Silvana Robone
Author-X-Name-First: Silvana
Author-X-Name-Last: Robone

Author-Name: Gilberto Turati
Author-X-Name-First: Gilberto
Author-X-Name-Last: Turati
Author-Email: gilberto.turati@unicatt.it
Author-Workplace-Name: Università Cattolica del Sacro Cuore
Author-Workplace-Name: Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore






Title: Does fiscal decentralization affect regional disparities in health? Quasi-experimental evidence from Italy.


Abstract: Recent theories on fiscal decentralization support the view that sub-national governments who
finance a larger share of their spending with taxes raised locally by themselves are more accountable
towards their citizens. Whilst evidence on improvements in spending efficiency is relatively
common, little is known about the effects on inequalities amongst the population. In this paper we
exploit a reform aimed at increasing regional tax autonomy in Italy to provide quasi-experimental
evidence on the impact of fiscal decentralization on health disparities between- and within-regions.
Our findings, robust to a number of robustness checks, support the view that fiscal decentralization
does not impact on between-regional inequalities but can help to reduce inequalities within regions.
However, this last effect depends on the degree of economic development: richer regions are better
than poorer ones in containing inequalities.
Length: 37
Creation-Date: 2019-07
File-URL: http://dipartimenti.unicatt.it/economia-finanza-def083.pdf
File-Format: Application/pdf
File-Function: First version, 2019
Number: def083
Classification-JEL: H75, I14, I15, I18, R50. 
Keywords: fiscal decentralization, regional governments, healthcare policy, health inequalities.
Handle: RePEc:ctc:serie1:def083