Please use this identifier to cite or link to this item: http://hdl.handle.net/10419/225055
Authors: 
Di Novi, Cinzia
Piacenza, Massimiliano
Robone, Silvana
Turati, Gilberto
Year of Publication: 
2019
Series/Report no.: 
Working Paper No. 83
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.
Subjects: 
fiscal decentralization
regional governments
healthcare policy
health inequalities
JEL: 
H75
I14
I15
I18
R50
Document Type: 
Working Paper

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