Cinzia Di Novi

Insecure, Sick and Unhappy? Well-Being Consequences of Temporary Employment Contracts

Abstract This paper investigates the influences of temporary contracts along several dimensions of well-being (physical and mental health, self-assessed health and happiness) for young Italian workers. Our paper contributes to the literature exploring some new aspects of the relationship between temporary jobs and well-being in a country not frequently analysed in previous literature. We focus on the gender gap in the well-being consequences of non-permanent jobs, the influence of financial support by family in reducing well-being effects caused by temporary contracts and the interaction between gender gap and family support. We find that temporary contracts are damaging in terms of psychological health and happiness mostly for young men and individuals without family economic support. On the other hand, women’s mental health is not affected by temporary contracts and they are even better off in terms of their mental health and well-being when receiving family economic support.

Accounting for Tax Evasion Profiles and Tax Expenditures in Microsimulation Modelling. The BETAMOD Model for Personal Income Taxes in Italy

The paper presents the main characteristics of BETAMOD, a static microsimulation model that reproduces the Italian personal income tax (IRPEF), as well as local income taxes, namely the regional and municipal additional income taxes, building on a detailed reconstruction of tax legislation. With respect to the vast majority of existing tax microsimulation models, the peculiarities of BETAMOD concern two aspects: the inclusion of a detailed set of tax expenditures, and the estimation of individual-specific tax evasion rates, which account for the total individual income level, its composition in terms of income sources, and the geographical area of residence.

Do healthcare tax credits help poor-health individuals on low incomes?

In several countries, personal income tax permits tax credits for out-of-pocket healthcare expenditure. Tax credits benefit taxpayers at all income levels by reducing their net tax liability and modify the price of out-of-pocket expenditure. To the extent that consumer demand is price elastic, they may influence the amount of eligible healthcare expenditure for which taxpayers may claim a credit. These effects influence, in turn, income distributions and taxpayers’ health status and therefore income-related inequality in health. Redistributive consequences of tax credits have been widely investigated. However, little is known about the ability of tax credits to alleviate health inequality. In this paper, we study the potential effects that tax credits for health expenses may have on income-related inequality in health status with reference to the Italian institutional setting. The analysis is performed using a tax-benefit microsimulation model that reproduces the personal income tax and incorporates taxpayers’ behavioral responses to changes in tax credit rate. Our results suggest that the current healthcare tax credit design tends to favor the richest part of the population.

How Does Fiscal Decentralization Affect Within-Regional Disparities in Well-Being? Evidence from Health Inequalities in Italy

This paper aims at investigating empirically the impact of fiscal decentralization reforms on inequality in well-being. In particular, we look at the effects on health inequalities following the assignment of larger tax power to the Italian Regions for financing their health expenditure, starting from the end of the Nineties. Exploiting large differences in the size of the tax base across Regions, we find that fiscal decentralization processes that attribute a greater tax power to lower government tiers, besides reducing inefficiencies of healthcare policies, seem to be effective in reducing also within-regional disparities in health outcomes. However, thedegree of economic development – on which depends the actual fiscal autonomy from Central government – significantly affects the effectiveness of these reforms and highlights the importance to take properly into account the specific features of the context where the decentralization of power is implemented.

Scale Effects and Expected Savings from Consolidation Policies of Italian Local Healthcare Authorities

BackgroundConsolidation is often considered by policymakers as a means to reduce service delivery costs and enhance accountability.ObjectiveThe aim of this study was to estimate the potential cost savings that may be derived from consolidation of local health authorities (LHAs) with specific reference to the Italian setting.MethodsFor our empirical analysis, we use data relating to the costs of the LHAs as reported in the 2012 LHAs’ Income Statements published within the New Health Information System (NSIS) by the Ministry of Health. With respect to the previous literature on the consolidation of local health departments (LHDs), which is based on ex-post-assessments on what has been the impact of the consolidation of LHDs on health spending, we use an ex-ante-evaluation design and simulate the potential cost savings that may arise from the consolidation of LHAs.ResultsOur results show the existence of economies of scale with reference to a particular subset of the production costs of LHAs, i.e. administrative costs together with the purchasing costs of goods (such as drugs and medical devices) as well as non-healthcare-related services.ConclusionsThe research findings of our paper provide practical insight into the concerns and challenges of LHA consolidations and may have important implications for NHS organisation and for the containment of public healthcare expenditure.

Lights and shadows of Affordable Care Act and its influence on world civilization

Purpose - The Obama’s reform of the US healthcare system has been a major topic of debate in the USA. The USA feels the need to provide 48 million residents with health insurance. The Affordable Care Act has this goal, but the several factors have limited its capacity and implementation. The purpose of this paper is to discuss this reform, paying attention to its potential implications for the human and economic development of both the USA and the rest of the world. The authors show that developed countries also need policies for enhancing human development and also the developing world may benefit from policy changes in the “first world.” Design/methodology/approach - The methodology is based on discursive discussion. The argumentation first presents the reform, and highlights its advantages and its flaws for the citizens of both the USA and of developing countries. Findings - The authors claim that the reform presents some flaws that render it still insufficient to cover all the health needs of the poor in the USA. However, the reform is likely to attract more immigrant workers to the USA, since it is likely to improve the living conditions of immigrants as well as those of their families. Originality/value - The original point of the paper is the link between the reform and the benefits for non-US citizens. The extant literature has widely discussed the impact of the reform on the domestic market and on the US citizens. The authors widen this perspective showing that an important reform in a large country may be beneficial for people living elsewhere as well.

Larger is Better: the Scale Effects of the Italian Local Healthcare Authorities Amalgamation Program

Consolidation is often considered as a means to lower service delivery costs and enhance accountability. This paper uses a prospective evaluation design to derive estimates of the potential cost savings that may arise from Local Healthcare Authorities (LHAs) amalgamation process, which is concerning the Italian National Health System. We focus specifically on cost savings due to scale economies with reference to a particular subset of the production costs of the LHAs, i.e. the administrative costs together with the purchasing costs of both goods as well as non-healthcare related services. Our results demonstrate the existence of economies of scale linked to the size of the LHA population. Hence, the decision to reduce the number of LHAs may result in larger local health authorities that are more cost efficient, especially when the consolidation process concerns merging a large number of LHA.