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Settori scientifico-disciplinari MIUR = Area 13 - Scienze economiche e statistiche: SECS-P/03 Scienza delle finanze
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Public Transit Subsidy: from the Economics of Welfare to the Theory of Incentives - Fabbri, Daniele
Public Transit is publicly managed almost all over Europe. Public intervention in this sector is due to market failures: economies of scale and misperceptions of social and private costs may cause an insufficient supply of transit services. These arguments have been thouroughly analyzed within the standard welfarist approach to the theory and practice of subsidization. Ramsey rules and cost-benefit analysis emerged as useful devices for the definition of subsidy allocation. However remedies to market failures should be traded-off against government failures. Lack of incentives, X-inefficiency, regulatory capture, bureaucracy power are common facts in the internal organization of public administration. If...
Tax Amnesties, Plea Bargains and the Optional Enforcement Policy - Franzoni, Luigi Alberto
This paper develops a model of tax enforcement in which the tax agency is allowed to make pre-audit settlement offers to taxpayers. Settlements can either take the form of public amnesties or individual plea bargains. In this model, pre-audit settlements allow the agency to overcome its limited control over the enforcement parameters (the agency takes the tax and penalty levels as given) and to increase its net revenue. Public amnesties prove to be superior to individual plea bargains, since they allow the agency to extract from taxpayers, not only the prospective defence cost, but also the risk premium associated with...
Prosecutorial Discretion and Criminal Deterrence - Franzoni, Luigi Alberto
This paper develops a model of law enforcement in which the indicted and the enforcer can negotiate the level of the penalty by means of a settlement. The emphasis of the analysis is on the credibility of the settlement other: the enforcer cannot threaten an incredibly large conviction rate if the negotiation fails. The introduction of the negotiation stage brings about several novel features of the optimal enforcement policy, one of which is the possibility that a ¯nite penalty is optimal (globally or locally). We show that the skimming process associated with the negotiation stage reduces the incentives for the...
Independent Auditors as Fiscal Gatekeepers - Franzoni, Luigi Alberto
This paper develops a framework for the analysis of gatekeeping in tax enforcement, whereby independent auditors are assigned the duty of certifying taxpayers` reports. The equilibrium of the market for gatekeepers` services is characterized, as well as taxpayers` and auditors` optimal behavior. The paper discusses the optimal structure of the gatekeeping regime and determines the conditions under which it is socially preferable to direct public enforcement.
Efficienza tecnica e produzione ospedaliera: una valutazione con Data Envelopment Analysis delle prestazioni ospedaliere nel periodo della riforma - Fabbri, Daniele
In questi ultimi anni il Sistema Sanitario Nazionale è stato sottoposto ad un sostanziale processo
di trasformazione e di riforma. Uno fra gli ambiti più investiti dalle trasformazioni in atto è
certamente quello della produzione di servizi ospedalieri. Nel quadro istituzionale che si va
delineando i produttori vengono sempre più responsabilizzati a perseguire strategie di
razionalizzazione nell’uso delle risorse e di razionamento della domanda. E’ in questo contesto
che il miglioramento dell’efficienza produttiva assume il valore di obiettivo prioritario. In questo
studio ci concentriamo sulla componente tecnica dell’efficienza nella produzione ospedaliera al
fine di valutare se e in quale misura le recenti riforme abbiano contribuito ad accrescerla.
Imperfect competition in certification markets - Franzoni, Luigi Alberto
This paper offers a theoretical analysis of imperfect competition in certification markets. Firms that intend to engage in a regulated activity must produce third-party certification of compliance with prescribed regulations and standards. The certification service is provided by independent certifiers competing
à la Cournot. We show that the interaction between certifiers and firms results in a market equilibrium that can be illuminated by the techniques of standard oligopoly theory. When certifiers’ liability is not too low, the certify cation fee is determined by the degree of concentration of the certification market. Due to the peculiarity of this market, a lower concentration...
Comportamenti di exit e razionamento nelle aziende sanitarie: il ruolo dei modelli di governo - Fabbri, Daniele
Nell’ambito della recente riforma l’AUSL è chiamata a perseguire simultaneamente tre obiettivi : il razionamento della domanda, il miglioramento dell’efficienza produttiva e la garanzia dei livelli di qualità delle prestazioni. Il contenimento eccessivo delle prestazioni terapeutiche erogate può indurre i pazienti assistiti all’exit dall’offerta ospedaliera garantita dalla AUSL di assistenza. Esiste quindi un trade-off fra razionamento e trattenimento della domanda. In questo lavoro si propone una valutazione delle strutture organizzative e di governo della AUSL più adatte ad affrontarlo. Vengono esaminate due tipologie di strutture: le AUSL che operano una completa integrazione fra finanziamento e produzione su una gamma molto...
New Criteria of Targeting Welfare in Italy: an Appraisal of the Distributive Effects - Baldini, Massimo; Bosi, Paolo; Toso, Stefano
Means-tested social assistance programs have acquired, in the last two decades, an increasing role in the majority of industrialised countries. Although the issue of whether social assistance should be targeted or universally granted remains a main subject of dispute (Harding et al. 1994; Mitchell 1995; Smolensky et al. 1995; Atkinson 1995, 1998), the shift towards targeting is in practice quite widespread, mainly reflecting the wish to curb social security budgets in a general context of fiscal restraint. The issue of targeting welfare assumes a particular importance in Italy, whose social assistance programs resemble more the rudimentary regimes typical of Southern...
The Optimal Allocation of Power in
Organizations - Carbonara, Emanuela
Starting from the separation between formal and real authority, the paper considers a hierarchical relation where delegation of control can be used as an incentive mechanism. It shows that delegation is optimal when parties’ interests are neither too divergent nor too close. In that case superiors do not need to monitor too closely, curbing the subor- dinates’ initiative and subordinates have no incentives to free ride on the superiors’ information. The analysis is then extended to a multi- period setting. If subordinates acquire expertise on the job (learning by doing), effort has the nature of a specific investment whose intrinsic...
Riforma Sanitaria e produzione ospedaliera - Fabbri, Daniele
La recente riforma del sistema di finanziamento ha reso gli ospedali responsabili dei risultati gestionali raggiunti, attribuendo loro una parte del rischio finanziario. In secondo luogo, ha reso più stringenti i vincoli di bilancio degli enti finanziatori con ripercussioni sugli incentivi al contenimento dei consumi e delle produzioni sanitarie. Infine ha ridimensionato le risorse a disposizione degli ospedali e ridisegnata la distribuzione dimensionale dell'offerta. Sono quindi all'opera almeno due dinamiche: una che tende ad incoraggiare i produttori alla riorganizzazione e all'ottimizzazione dei processi produttivi a risorse date, e una che tende, nello stesso tempo, a ridimensionare le risorse a loro...
Transizione demografica e formazione del risparmio delle famiglie italiane. - Baldini, Massimo; Mazzaferro, Carlo
This paper studies the relationship between population ageing and saving formation by Italian households. We use five cross-sectional budget surveys to separately construct the age and cohort profiles of the saving rate. After detrending the data, we isolate the age and cohort effects on saving. Cohort effects show that, in the current Italian population, saving behaviour is markedly different across generations. The estimates obtained on survey data are then used to derive a forecast of the medium and long run tendency of the household saving rate (2000-2050). In the absence of any changes in the saving behaviour of young cohorts,...
Punishment and Grace: On the Economics of Permanent Amnesties - Franzoni, Luigi Alberto
This paper extends the literature on tax amnesties by consid-ering two special grace programmes. The first is an offer by the government not to investigate taxpayers' accounts, the second not to prosecute indicted evaders. I analyse the impact of both measures on the taxpayers' optimal behaviour and the government's net revenue, and derive the conditions under which it would be desir-able to implement them on a permanent basis.
Reforming the Personal Income Tax and the Family Allowance in Italy: A Proposal - Matteuzzi, Massimo; Toso, Stefano
We illustrate a proposal to reform the personal income tax and the family allowance in Italy which aims at attaining a fair tax treatment of the family, laying emphasis on the redistributive processes in favour of large and poor households. Our proposal is based on a simplification of the tax rate schedule (with a reduction of income brackets) and a new design of the tax credits for dependents which implies the fiscal exemption of a sort of basic income, which is decreasing as the income of the household increases. The new scheme of supplementary tax credits for dependents, related to...
La Stima di Frontiere di Costo nel Trasporto Pubblico Locale: una Rassegna e un'Applicazione - Fabbri, Daniele
In questo lavoro si esamina la recente letteratura di analisi dell’efficienza produttiva e di costo attraverso la stima di frontiere di costo e di produzione nel settore del trasporto pubblico locale. Nell’ultima parte dell’articolo presentiamo uno studio sul settore del trasporto pubblico locale in Emilia-Romagna. La funzione specificata è di costo variabile. Il modello, stimato con dati panel, è del tipo uniequazionale con fixed effects. I risultati della stima indicano la presenza di ingenti economie di scala, sia di breve che di lungo periodo, secondo un andamento che decresce al crescere della dimensione aziendale. La stima degli indicatori di inefficienza...
Corruption and Decentralization - Carbonara, Emanuela
This paper studies the effect of decentralization on corruption in a hierarchical organization, where decentralization is intended as the delegation of control power to lower levels in a hierarchy. Decentral- ization causes a loss in control to the higher levels, thus curbing their incentives to monitor and detect corrupt activities. However, it also lowers the expected gains from corruption as, following decentralization, the number of individuals who are in charge of a single decision is reduced. It is then more likely that corrupt agents are called to bear the consequences of their actions. Hence, decentralization, although creating agency problems inside...
Public vs. Private Health Care Services Demand in Italy - Fabbri, Daniele; Monfardini, Chiara
In this paper we use data coming from the new Italian Survey on Health Ageing and Wealth
(SHAW) to analyse physician services utilization in Italy explicitly acknowledging the existence of two different classes of providers: public and private. We consider visits by a specialist physician as the measure of individual services utilization. In particular we assess the relative importance of variables like income, education, private insurance and supply characteristics as determinants of the utilization of such services, while controlling for individual health and need. We do that by estimating some alternative count data regression models of which we discuss the relative...
Style of practice and assortative mating: a recursive probit analysis of cesarean section scheduling in Italy - Fabbri, Daniele; Monfardini, Chiara
We study practice variation in scheduling of cesarean section delivery across public and private
hospitals in Italy. Adopting a novel perspective, we look at the role played by patients’ preferences
for the treatment. The recursive probit model is revisited as a useful tool to assess the presence of
assortative mating of patients and provider driven by style of practice. According to our evidence the
propensity to scheduling a cesarean section is codetermined with patient self-sorting into hospital
types. We measure a significantly higher inclination to practice cesarean section scheduling in
private hospitals and conclude that assortative mating is of minor relevance in our case, even if...
Economic Incentives in General Practice: the Impact of Pay for Participation Programs on Diabetes Care. - Lippi Bruni, Matteo; Nobilio, Lucia; Ugolini, Cristina
Financial incentives are increasingly adopted to improve allocative efficiency and quality in primary care. Although it has been recognised that incentive-based remuneration schemes can have an impact on GP behaviour, there is still weak empirical evidence on the extent to which such programs influence healthcare outcomes and on the degree of physicians’ responsiveness to their introduction. This problem reflects the lack of adequate empirical data but also the complexity of general practice systems where many confounding and institutional factors are likely to influence physician behaviour. Given this background, we investigate the impact on quality of care of the introduction of...
Incentives In Primary Care and Their Impact on Potentially Avoidable Hospital Admissions - Fiorentini, Gianluca; Iezzi, Elisa; Bruni, Matteo Lippi; Ugolini, Cristina
Financial incentives in primary care have been often introduced with the purpose of improving
appropriateness of care and containing demand. We usually observe pay-for-performance programs,
but alternatives have been also implemented, such as pay-for-participation in improvement
activities and pay-for-compliance with clinical guidelines. Here, we assess the influence of different
programs which ensure extra-payments to GPs, for containing episodes of avoidable
hospitalisations. Our dataset covers patients and GPs of the Italian region Emilia-Romagna for year
2005, and we control for a wide range of factors potentially influencing GPs’ behaviour. By
separating pay-for-performance from pay-for-participation and pay-for-compliance programs, we
estimate the impact on the probability of (inappropriate) hospitalisation of financial...
Opt out or Top up? Voluntary Healthcare Insurance and the Public vs. Private Substitution - Fabbri, Daniele; Monfardini, Chiara
We investigate whether people enrolled into voluntary health insurance (VHI) substitute public consumption with private (opt out) or just enlarge their private consumption, without reducing reliance upon public provisions (top up). We study the case of Italy, where a mixed insurance system is in place. To this purpose, we specify a joint model for public and private specialist visits counts, and allow for different degrees of endogenous supplementary insurance coverage, looking at the insurance coverage as driven by a trinomial choice process. We disentangle the effect of income and wealth by going through two channels: the direct impact on the...