In this article we show that when the provision of paternalistic goods is entwined with income distribution, the political decision process may prevent welfare maximization. We model the decision process from a political economy perspective by assuming that the quantity of a paternalistic good...

The organisation of inpatient care provision has undergone significant reform in many southern European countries. Overall across Europe, public management is moving towards the introduction of more flexibility and autonomy . In this setting, the promotion of the further decentralisation of...

This paper aims at assessing the impact of fiscal discipline towards sub-national governments on citizens’ well-being. We model fiscal discipline by considering the expectations of deficit bailouts by Central Government, and focus on a particular dimension of well-being, namely health outcomes...

In recent years, decentralization of financial and political power has been perceived as a useful means to improve outcomes of the health care sector. Such reforms are often a result of fashion, rather than being based on knowledge of “what works”. If decentralization is the favored strategy...

This study considers the discretionary premium-setting behavior of municipalities in the Japanese system of long-term care insurance (LTCI). Although, the LTCI system is managed by the municipality, but the financial system is controlled by national health insurers, and the municipality seems to...

Millions of people in the developing world lack access to curative drugs. Thomas Pogge identifies the cause for this problem in a lack of redistribution across borders. By contrast, this article shows that institutional shortcomings within developing countries are the main issue. The different...

In this essay a conceptual and theoretical scheme for decentralized integrated health care systems of the northern European kind is developed. With small changes it is also applicable to other countries, e.g. Italy, Spain, and Portugal. Three ideas tie together the scheme: modified fiscal...

Recent policy developments in public health care systems lead to a greater diversity in health care. Decentralisation, either geographically or at an institutional level, is the key force, because it encourages innovation and local initiatives in health care provision. The devolution of...

Recent policy developments in public health care systems lead to a greater diversity in health care. Decentralisation, either geographically or at an institutional level, is the key force, because it encourages innovation and local initiatives in health care provision. The devolution of...

The organisation of inpatient care provision has undergone significant reform in many southern European countries. Overall across Europe, public management is moving towards the introduction of more flexibility and autonomy . In this setting, the promotion of the further decentralisation of...