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RPS 3 2017

È online il numero 3/2017 di Rps. Il fascicolo dedica la sezione monografica al futuro dei diritti sociali in Europa. Nella sezione Attualità si discute di politiche fiscali e welfare.

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health policies

Mimmo Lucà

Articolo scritto da:

As President of the Parliamentary Commission on Social Affairs I’d like to offer a few brief thoughts on the subjects introduced here and on which there has been a discussion, offering an institutional point of view on the path to follow. I refer in particular to the law on non-self-sufficiency, which is being discussed by the Commission I chair, and which comes from a failure in the previous Parliament. The Hon. Zanotti dealt with it in the last Parliament, and this time too, there is a risk of it finishing on the rocks of financial covering. This law is based on the setting up of the Fund for non-self-sufficiency, and it is clear that if this fund is not adequately financed with the necessary resources to guarantee an essential level of services, then the law cannot be approved.only subscribers can see the full article

Supplementary Health Insurance

Articolo scritto da:

in the issue
Nhs
The author suggests a reflection on the wide theme of supplementary health insurance schemes, which could help to clarify the real or presumed risks of their diffusion and on the definitions of the most opportune modalities and measures to contrast the risks of diversified access to care services. Considering rather simplistic an analysis which looks at the presence of these schemes as an alternative to the Nhs, the author insists on the centrality of an efficient and effective distribution of essential levels of care. At the same time, he considers opportune and advantageous to overcome hostile positions, that are often the prelude to mechanisms of progressive adaptation that lead to unsatisfactory benefits.only subscribers can see the full article

Economic Evaluation in Care and Health Services

Articolo scritto da:

Population ageing and technological development in industrialised countries have helped bring to the fore the subject of the efficient allocation of resources in welfare systems. In the health sector, economic evaluation is a tool designed to guide allocation decisions in relation to a crucial dimension of the problem: the opportunity cost. Since the 1960’s a strong increase in the number of studies has been noted particularly in the pharmacological sector, and in many countries the results of these studies have been used to issue specific guidelines. only subscribers can see the full article

Achille Passoni

Articolo scritto da:

I want first of all to dwell on some questions that were dealt with today by the Minister for Social Policy, Paolo Ferrero, which, quite honestly, I find difficult to share. First of all, the question of the Social Policy Fund. The resources to transfer to the Regions in 2007, compared with those transferred in 2006, have indeed increased — and we much appreciate this — but only to an extent equal to the cuts made by the previous government last year. That means that the Fund now stands at the same figure as in 2004. Substantially, there has been no additional investment since then down to the end of 2007. And this means that social policies and combating poverty are not seen as a priority by the new Centre-Left government. The Minister will agree with me that this is not at all good news. only subscribers can see the full article

Health Services in Europe: Decentring and Re-Centralization

Articolo scritto da:

in the issue
Europe and Regions
The article offers a comparative account of the situation of the institutional set-ups for health services adopted in various countries of western Europe. The health service is one of the main fields in which the processes of decentring have been most marked and debated over the years. This study shows how it is not possibile to identify one trend and timing for all western countries. The type of model adopted (insurance-based or a national health service), like belonging to different welfare «families» (the Scandinavian, English, continental or Mediterranean ones), influence the course taken in recent decades by the various public health systems in terms of decentring and, in some cases, of re-centralization.only subscribers can see the full article

Three Years of Isee: Evidence and Assessment

Articolo scritto da:

in the issue
Nhs
This paper offers a concise overview of evidence from the Isee 2004 Report, which has just been published by the Cabinet and the Employment Department thus providing an updated framework of the provisional data for 2004. A critical evaluation of the Isee can now be given after the first three years in activity as the sole tool wanted by the legislator for the selectivity in social policies. Various problems are here discussed, from the role of immovable and moveable assets to the difficulty in guaranteeing horizontal equity with the Isee given widespread hidden incomes. Particular attention is placed on the matter of the singular criterion for the different services, distinguishing it from the problem of the single information system, a resource to be reinforced and valorised.only subscribers can see the full article

The Integration that We Lack, and that We Need

Articolo scritto da:

I want first of all to concentrate on one important aim that has guided Rps in organising this Forum on welfare integration: placing the accent on the concept of «integration» rather than on that of «social-health», understood as a system of services, and this aim is particularly important for me. We can talk about welfare integration in various ways, meaning aspects that are also very different and potentially in conflict with each other. On the one hand, we hear talk of social-health integration as if it were the more or less official name for a sector, a synonym of the social-health sector, that accompanies the health and the care sectors. only subscribers can see the full article

Universalism and Technological Development: Germany, the Uk and the Usa

Articolo scritto da:

in the issue
Nhs
The paper gives an overview of the historical evolution and characteristics of the s in Germany, the Uk and the Usa. The article also proposes an economic interpretation of differences between the three countries. Germany and the Uk, through different models, assure universal access to health services. In the Usa the residual role of public funding doesn’t manage to make up for shortcoming in the private sector, leaving almost a third of the population without any insurance or with insufficient insurance coverage. High health spending in the Usa, incrementing the diffusion of increasingly expensive new technologies and therapeutic approaches, can put universalistic systems under pressure. To maintain the present structure of European health systems, it is necessary to manage the diffusion of new technologies.only subscribers can see the full article

Good Management and Appropriateness of Services

Articolo scritto da:

This contribution is intended to answer two questions: 1) what do we mean by cost-performance, efficiency and efficacy; 2) why do we now talk about appropriateness. We can define these terms as follows: * cost-performance means conforming and responding to principles of economics in the sense of parsimony and saving; * efficiency is the situation of maximum productive capacity, at minimum possible costs, in a combination of production or supply of goods and/or services; * efficacy is the capacity to fully produce the desired effect and the obtaining of it. Nothing can be managed, still less managed well, that is, there can be no administration of the goods and/or interests for others, if the principles of cost-performance, efficiency and efficacy are not borne in mind and applied. only subscribers can see the full article

Paolo Ferrero

Articolo scritto da:

First of all I’d like to thank you for your invitation to contribute to this Forum. Various problems seem to have emerged, and I’d like to try and talk about them. Apart from some criticisms relating to questions of organisation, I particularly want to draw attention to a specific problem, that of the essential levels of care, with special reference to the question of non-self-sufficiency. I want to talk about it in cultural as well as political terms, though in this latter sense our policy on this should start to be implemented in the next few months. I start from one element for evaluating the present situation. It seems to me obvious that — and here I agree with the judgments given — the social sector is much less protected in the constitution than the health sector. Traditionally there has always been a strong difference in the level of services in our country.only subscribers can see the full article