On the Fuzzy Boundaries between Public and Private in Health Care Organization and Funding Systems

The paper proposes a survey of health care organization and funding systems in order to underline and discuss, in this specific field of social assistance, the combination public versus private provision and production of services. The survey then examines the present features of various National health services focusing on the efficiency and equity of public intervention and on the industrial organization of the institutional design of health care. In this context, it treats the rationale of cost-benefit of vertical integration of structures, devoted respectively to purchasing and providing health care services. Further, the paper considers the advantages and disadvantages of managed competition in quasi-markets and, finally, it deals with insurance systems, social as well private and supplementary ones. From the survey it turns out that the main distinctions of health care regimes in industrialised countries are not in terms of private versus public ownership of providers, rather in terms of industrial organization setting and in terms of the proportion of public versus private expenditure.Health care organization, health care funding, social insurance, private and public provision.

The impact of productive efficiency and quality of a regulated local public utility on final goods prices and consumers welfare

In this paper, we reconstruct the process by which the decisions of a regulated local public utility, in terms of productive efficiency and quality of the service provided, impact on prices of final consumption goods, supplied in a oligopolistic market operating in the same geographic area. We obtain some formula for these effects which can be quantified by estimating firms’ conditional input demand function of the public service and firms’ inverse demand function for this public good, non-rival, component. Finally, we draw the effects of productive efficiency and quality on consumer welfare and cost-of-living, via changes on tariffs, external effects and final goods prices.regulation, x-efficiency, oligopoly, consumer welfare

Earmarked Taxation for Financing Public Investments Projects

This paper deals with the earmarked taxation employed by local governments for fi…nancing public investments projects carried on with some Public-Private Partnerships con…figurations. First, we analyse the theoretical pro…files of earmarked taxation by using the tax-benefi…t approach, and the theory of political competition and accountability. Second, on the ground of the P-P-P literature, we examine the trade-off between fi…nancing mechanisms based on public subsidies to the concessionaire fi…rm, fi…nanced by a earmarked tax, and mechanisms based on users-fees. Then, we discuss cases where the …rst solution turns out to be, even partially, preferred. Finally, we consider the potential role of earmarked taxation on the Italian institutional context, emerging from the recent legislation on fi…scal federalism and municipalities taxation.Earmarked taxes, cost of public funds, subsidies, public investments

Revenue Equalization Systems in a Federation with Tax Evasion

We analyse how vertical or horizontal fiscal equalization affects the overprovision of local public goods due to vertical fiscal externality, when there is tax evasion. The regional governments overspending incentive is examined both in case of a fiscal equalization based on pretax earned income and reported taxable income.Fiscal federalism; Equalization; Marginal Cost of Public Funds, Tax evasion

Economics of Institutions and Law

This book provides a set of lectures for an intermediate course in Public economics devoted to four topics, in many elements related each other. The first one is the Economics of institutions and political economy, as a general framework to analyze the public intervention in modern economies. The second one is the Economics of Law, which is at the basis of the working of the exchange economy. The third one is the Economics of public services enterprises ownership and the fourth one is the Economics of the organization of public administration in providing public services, with particular reference to the National health care systems and to the local public municipalities. As the standard textbooks in the field usually do not treat within unitary and comprehensive terms these issues, the book would provide an attempt in this direction

Competition between State Universities

We analyse how state university competition to collect resources may affect both research and the quality of teaching. By considering a set-up where two state universities behave strategically, we model their interaction with potential students as a sequential noncooperative game. We show that different types of equilibrium may arise, depending on the mix of research and teaching supplied by each university, and the mix of low- and high-ability students attending each university. The most efficient equilibrium results in the creation of an élite institution attended only by high-ability students who enjoy a higher teaching quality but pay higher tuition fees.university competition, research, tuition fees

Competition between State Universities

We analyse how state university competition to collect resources may a¤ect both the quality of teaching and research. By considering a set-up where two state universities behave strategically, we model their interaction with potential students as a sequential noncooperative game. We show that di¤erent types of equilibrium may arise, depending on the mix of research and teaching activity supplied by each university, and the mix of low and high ability students attending each university. The most e¢ cient equilibrium results in the creation of an élite institution attended only by high ability students. Low ability students are segregated in the other university, but obtain the same teaching quality level and pay the same tuition fees.University Competition, Research, Tuition Fees

Public-Private Partnership and competition in Health-Care and Education

Even if both the health and the educational sector are under the state supervision in basically all countries, there are wide differences in the mix of their public/private provision and financing across them. The debate on the proper mix between private and public involvement has also been re-enlightened by the recent financial crisis which has stressed many countries’ public finances. The aim of this paper is twofold. First, it aims at presenting the incentive and competition mechanisms both for the public and the private sector behind different types of mix between private and public involvement according to the industrial organization design of the health and the educational sector. Second, the paper aims at presenting some recent case studies on Public Private Partnerships in both the health and the educational sector in countries such as the UK, the USA, the Netherlands, and Australia