Dino Rizzi

Health, Welfare and Inequality

This paper uses data from the Health and Retirement Study (HRS) to study the relationship between health status and economic welfare at household level. We develop a model to estimate the welfare cost of ill health by exploiting the methodology of the equivalence scales. The crucial variables in this approach are, besides the health status (measured in several dimensions), the economic decisions of the household which can be directly related to health conditions, such as health-related expenses. By estimating a demand system we derive health-equivalence scales to learn about the cost of health conditions on economic welfare, controlling for other covariates. Our estimates suggest that � when taking account of health � the welfare of households in poor health drops substantially and inequality increases. There are important social welfare costs associated with differences in the health status of the elderly in the USA.

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.

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.

Tax Evasion Indices and Profiles

The aim of this article is to adapt definitions and tools currently used in the economic literature on poverty to individual data on tax evasion. The article presents composite indices and profiles of tax evasion based on the three I’s of tax evasion: incidence, intensity, and inequality, following the approach of Shorrocks’s study and Jenkins and Lambert’s study that proposed the three I’s of poverty. In the field of tax evasion, one stream of literature produces a potentially large amount of individual microdata using tax benefit and agent-based models: the article enriches the analysis offered by these models with indices that take into account the entire distribution of taxpayer evasion rates. Particularly, the article presents a new composite index of tax evasion that incorporates a concentration index of individual tax evasion rates. A final section shows a sensitivity analysis of tax evasion indices and profiles through numerical simulations.

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.

A Procedure for the Ex-Ante Assessment of Compulsory Municipal Amalgamation Programs

The aim of the paper is to develop a procedure that allows policy makers to make an ex-ante assessment of a general compulsory amalgamation policy, providing quantitative indications about the possible financial effects. The amalgamation of small municipalities is a widespread practice all over the world. This policy is based on the assumption that local public service provision is characterized by economies of scale and economies of scope. However, population size is not the only determinant of economies of scale, which depend on many other factors. For these reasons, the expected effects of any amalgamation program are uncertain, and ex-post empirical analyses are unable to offer unambiguous indications to policy makers since all programs differ. After a brief discussion of the relevant issues concerning amalgamation, we present the procedure used to simulate the economics and administrative effects of a general compulsory amalgamation policy. The procedure is tested with reference to the municipalities of Veneto, a region of Italy and we provide the results of a number of simulations under alternative amalgamation policies. The main result is that amalgamation policies based only on the a priori rule that small municipalities should merge may be very inefficient because the expenditure reduction following an amalgamation policy may depend to a considerable extent on other territorial and socio-economic characteristics of the municipalities involved.

Standard Spending Needs of Italian Municipalities

Standard spending needs of municipalities, a crucial aspect of fiscal federalism, should be computed under some conditions: that municipalities have the same efficiency, that citizens have the same preferences, and, especially, that local governments are equal with regard to some «non structural» characteristics. The fitted values obtainable from the estimate of an expenditure function do not satisfy these conditions. Standard spending needs are better represented by conditional expected values, which are obtained by sterilizing differences in non structural determinants of municipality expenditures, like government grants. To compute spending needs we define two standard levels: an «average» standard and a «minimal» standard, which is defined as the minimum amount of resources that allows municipalities to provide a sufficient level of services. The method is applied to 2007 data of Italian municipalities.

Una valutazione della capacità di erogazione delle fondazioni bancarie del nord-est

Una valutazione della capacita di erogazione delle fondazioni bancarie del nord-est (di Stefania Funari e Dino Rizzi) - ABSTRACT:In this paper we analyse the performance of some banking foundations situated in the North-Eastern area of Italy. The performance is defined as the ability of a bank foundation to obtain revenues from their assets and to maximise its grant-making activity. To build a performance indicator we use an operational research methodology called Data Envelopment Analysis(DEA), applied to a model in which the variables are represented by budget ratios. Moreover a windows analysis is undertaken in order to examine the change of the performance of the bank foundations in the time period analysed.