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N. 130 (2024)

The warranty-based healthcare system: An innovative approach in public health for the “new normal scenario”

DOI
https://doi.org/10.3280/mesa2024-130oa18961
Inviata
dicembre 5, 2024
Pubblicato
2025-05-14

Abstract

Health protection is a goal that every State pursues. The WHO defines health as “a state of physical, spiritual, mental, and social well-being and not the mere absence of disease”. Public healthcare systems are mainly financed through taxation, and they often overspends.
For this reason, these systems are being reformed to increase efficiency while maintaining high effectiveness.
Private healthcare systems make patients cover their health
expenditure, which may be challenging.
The warranty-based healthcare system is suggested as a new, innovative model that is activated as a public healthcare system but investigates individual responsibility for the disease so patients may be asked to share part of the expense. This paper aims to show that this model is suited to the post Covid-19 pandemics “new normal scenario” and can achieve greater economic sustainability than the Italian SSN and the Beveridge healthcare models. This work aims to contribute to previous literature by introducing new perspectives in an increasingly topical public health debate.

Riferimenti bibliografici

  1. Anand S., Bärnighausen T. (2004). Human resources and health outcomes: cross-country econometric study. Lancet, 364(9445): 1603-1609.
  2. Armitage G., Suter E., Oelke N., & Adair C. (2009). Health systems integration: State of the evidence. International Journal of Integrated Care, 9. -- Retrieved from http://www.ijic.org/.index.php/ijic/article/viewArticle/316/630.
  3. Balboni E. (2001). Il concetto di “livelli essenziali e uniformi” come garanzia in materia di diritti sociali.
  4. Balduzzi R., & Carpani G. (Eds.) (2013). Manuale di diritto sanitario. Bologna: il Mulino.
  5. Barta J. A., Powell C. A., & Wisnivesky J. P. (2019). Global epidemiology of lung cancer. Annals of Global Health, 85(1).
  6. Bell E., Harley B., & Bryman A. (2022). Business research methods. Oxford University Press.
  7. Benartzi S., Beshears J., Milkman K. L., Sunstein C. R., Thaler R. H., Shankar M., ... & Galing S. (2017). Should governments invest more in nudging?. Psychological science, 28(8): 1041-1055.
  8. Berwick D. M., & Hackbarth A. D. (2012). Eliminating waste in US health care. Jama, 307(14): 1513-1516.
  9. Böhm K., Schmid A., Götze R., Landwehr C., & Rothgang H. (2013). Five types of OECD healthcare systems: empirical results of a deductive classification. Health policy, 113(3): 258-269.
  10. Bonini N., Del Missier F., & Rumiati R. (2008). Psicologia del giudizio e della decisione. Bologna: il Mulino.
  11. Borgonovi E. (2008). La tutela della salute è il fine, il funzionamento dei sistemi e delle aziende è il mezzo. Milano: Egea.
  12. Borgonovi E. (2013). Le aziende del SSN e il processo manageriale incompiuto. Le esigenze di cambiamento sono indipendenti dalle caratteristiche di governo. Sipis srl.
  13. Boslaugh S. E. (2013). Health care systems around the world: a comparative guide. Sage Publications.
  14. Breyer F., & Felder S. (2006). Life expectancy and health care expenditures: a new calculation for Germany using the costs of dying. Health policy, 75(2): 178-186.
  15. Broccolo F. (2010). Aterosclerosi: Eziopatogenesi, prevenzione e trattamento. Springer Science & Business Media.
  16. Burrai F., Gambella M., Scarpa A., & Cabula S. (2021). Metodologia e produzione delle Linee Guida. Giornale di Clinica Nefrologica e Dialisi, 33(1): 136-140.
  17. Callahan D. (Ed.) (2000). Promoting healthy behavior: how much freedom? whose responsibility?. Georgetown University Press.
  18. Capano G., & Gualmini E. (Eds.) (2011). Le pubbliche amministrazioni in Italia. Bologna: il Mulino.
  19. Cappelen A. W., & Norheim O. F. (2006). Responsibility, fairness and rationing in health care. Health policy, 76(3): 312-319.
  20. Carè R. (2016). Finanziamento e sostenibilità del Sistema Sanitario Italiano: analisi e prospettive. Edizioni del Faro.
  21. Catelani A. (2010). La sanità pubblica (Vol. 40). Wolters Kluwer Italia.
  22. Cawley J., & Ruhm C. J. (2011). The economics of risky health behaviors. In: Handbook of health economics (Vol. 2, pp. 95-199). Elsevier.
  23. Chaloupka F. J., Yurekli A., & Fong G. T. (2012). Tobacco taxes as a tobacco control strategy. Tobacco control, 21(2): 172-180.
  24. Cilione G. (2005). Diritto sanitario: profili costituzionali e amministrativi, ripartizione delle competenze, organizzazione, prestazioni, presidi sanitari privati, professioni: con riferimenti normativi bibliografici e giurisprudenziali. Maggioli Editore.
  25. Corrales L., Rosell R., Cardona A. F., Martin C., Zatarain-Barrón Z. L., & Arrieta O. (2020). Lung cancer in never smokers: The role of different risk factors other than tobacco smoking. Critical reviews in oncology/hematology, 148, 102895.
  26. Crawford R. (1977). You are dangerous to your health: the ideology and politics of victim blaming. International journal of health services, 7(4): 663-680.
  27. DeCicca P., & McLeod L. (2008). Cigarette taxes and older adult smoking: Evidence from recent large tax increases. Journal of health economics, 27(4): 918-929.
  28. de Groot P. M., Wu C. C., Carter B. W., & Munden R. F. (2018). The epidemiology of lung cancer. Translational lung cancer research, 7(3), 220.
  29. de Meijer C., Wouterse B., Polder J., & Koopmanschap M. (2013). The effect of population ageing on health expenditure growth: a critical review. European Journal of Ageing, 10(4): 353-361.
  30. Del Vecchio M. (2004). Il sistema di finanziamento delle aziende sanitarie pubbliche: un’interpretazione. In: Jommi C. Il sistema di finanziamento delle aziende sanitarie pubbliche. Milano: Egea.
  31. Di Girolamo A. S. (2007). Livelli essenziali e finanziamento dei servizi sanitari alla luce del principio di leale collaborazione. Istituzioni del federalismo: rivista di studi giuridici e politici, (3): 481-505.
  32. Emanuel E. J., & Emanuel L. L. (1996). What is accountability in health care?. Annals of internal medicine, 124(2): 229-239.
  33. Engelhardt H. T. (1997). Freedom and moral diversity: the moral failures of health care in the welfare state. Social Philosophy and Policy, 14(2): 180-196.
  34. Evans J. M., Baker R. G., Berta W., & Jan B. (2014). The evolution of integrated health care strategies. Annual review of health care management: Revisiting the evolution of health systems organisation.
  35. Fabbri D., & Monfardini C. (2003). Public vs. private health care services demand in Italy. Giornale degli economisti e annali di economia, 93-123.
  36. Ferré F., de Belvis A. G., Valerio L., Longhi S., Lazzari A., Fattore G., ... & World Health Organization (2014). Italy: health system review.
  37. Fitzmaurice C., Dicker D., Pain A., Hamavid H., Moradi-Lakeh M., MacIntyre M. F., ... & Global Burden of Disease Cancer Collaboration (2015). The global burden of cancer 2013. JAMA oncology, 1(4): 505-527.
  38. Gallus S., & Lugo A. (2019). Fumo di tabacco e tumore del polmone. Tabaccologia, 2: 14-16.
  39. Gardini E. (2020). Salute pubblica, libertà individuale e controllo sociale. Le vaccinazioni obbligatorie in Italia. Salute e società, 2.
  40. Giorgetti R. (2016). Legislazione e organizzazione del servizio sanitario. Maggioli Editore.
  41. Gravelle J., & Zimmerman D. (1994). Cigarette taxes to fund health care reform. National Tax Journal, 47(3): 575-590.
  42. Grossman M., Sindelar J. L., Mullahy J., & Anderson R. (1993). Policy watch: alcohol and cigarette taxes. Journal of Economic Perspectives, 7(4): 211-222.
  43. Guiducci P. L. (1999). Manuale di diritto sanitario (Vol. 23). Milano: FrancoAngeli.
  44. Hagenaars L. L., & Klazinga N. S. (2021). Prevention as a strategy for fiscally sustainable healthcare. Reducing paper and sugar for fiscally sustainable healthcare systems, 95.
  45. Halpern D., & Sanders M. (2016). Nudging by government: Progress, impact, & lessons learned. Behavioral Science & Policy, 2(2): 52-65.
  46. Hecht S. S. (1999). Tobacco smoke carcinogens and lung cancer. JNCI: Journal of the National Cancer Institute, 91(14): 1194-1210.
  47. Hoover D. R., Crystal S., Kumar R., Sambamoorthi U., & Cantor J. C. (2002). Medical expenditures during the last year of life: findings from the 1992-1996 Medicare current beneficiary survey. Health services research, 37(6): 1625-1642.
  48. International Agency for Research on Cancer (2012). A review of human carcinogens: personal habits and indoor combustions.
  49. Jiménez C., Manrique A., Marqués E., Ortegz P., Loinaz C., Gómez R., ... & Moreno E. (2007). Incidence and risk factors for the development of lung tumors after liver transplantation. Transplant International, 20(1): 57-63.
  50. Jommi C. (2000). I meccanismi regionali di finanziamento delle Aziende Sanitarie. L’aziendalizzazione della sanità in Italia. Rapporto OASI, 71-92.
  51. Jommi C., & Del Vecchio M. (2004). I sistemi di finanziamento delle aziende sanitarie nel Servizio sanitario nazionale.
  52. Knowles J. (1977). The responsibility of the individual. Daedalus.
  53. Lal A., Erondu N. A., Heymann D. L., Gitahi G., & Yates R. (2021). Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage. The Lancet, 397(10268): 61-67.
  54. Lamotte M. (2016). Fattori di rischio cardiovascolare e attività fisica. EMC-Medicina Riabilitativa, 23(2): 1-6.
  55. Lowenfels A. B., & Maisonneuve P. (2002). Epidemiologic and etiologic factors of pancreatic cancer. Hematology/Oncology Clinics, 16(1): 1-16.
  56. Lowenfels A. B., Maisonneuve P., DiMagno E. P., Elitsur Y., Gates Jr L. K., Perrault J., ... & International Hereditary Pancreatitis Study Group (1997). Hereditary pancreatitis and the risk of pancreatic cancer. Journal of the National Cancer Institute, 89(6): 442-446.
  57. Lubitz J. D., & Riley G. F. (1993). Trends in Medicare payments in the last year of life. New England journal of medicine, 328(15): 1092-1096.
  58. Mapelli V. (2012A). Il sistema sanitario italiano. Bologna: il Mulino.
  59. Mapelli V. (2012B). Pubblico e privato nella sanità italiana.
  60. Martin S., Rice N., & Smith P. C. (2008). Does health care spending improve health outcomes? Evidence from English programme budgeting data. Journal of Health Economics, 27(4): 826-842.
  61. Midha S., Chawla S., & Garg P. K. (2016). Modifiable and non-modifiable risk factors for pancreatic cancer: A review. Cancer Letters, 381(1): 269-277.
  62. Ministero della Salute (2020). L’incidenza dei tumori in Italia, -- https://www.salute.gov.it/imgs/C_17_notizie_3897_1_file.pdf.
  63. Mussari R. (Ed.) (2002). Il Controllo di gestione nell’amministrazione finanziaria dello Stato: l’esperienza dell’Agenzia delle entrate. Rubbettino Editore.
  64. Nixon J., & Ulmann P. (2006). The relationship between health care expenditure and health outcomes. The European Journal of Health Economics, 7(1): 7-18.
  65. Nolte E., McKee M., & Wait S. (2005). Describing and evaluating health systems (pp. 12-43). Maidenhead: Open University Press.
  66. Or Z. (2001). Exploring the effects of health care on mortality across OECD countries.
  67. Parkin D. M., Pisani P., Lopez A. D., & Masuyer E. (1994). At least one in seven cases of cancer is caused by smoking. Global estimates for 1985. International journal of cancer, 59(4): 494-504.
  68. Pasini N. (1998). Etica e giustizia in sanità. In: Cattorini. Milano: FrancoAngeli.
  69. Ragioneria Generale dello Stato (2022). Monitoraggio della spesa sanitaria 2022. -- https://www.rgs.mef.gov.it/VERSIONE-I/attivita_istituzionali/monitoraggio/spesa_sanitaria/#:~:text=Il%20monitoraggio%20della%20spesa%20sanitaria%20%2D%20anno%202022&text=9%20“%20Il%20monitoraggio%20della%20spesa,risultanze%20dell%27attività%20di%20monitoraggio.
  70. Razavi A., Erondu N., Okereke E. (2020). The Global Health Security Index: What value does it add?. BMJ Glob Health, 5, e002477.
  71. Rebba V. (2013). Il futuro dei sistemi sanitari pubblici tra universalismo e sostenibilità. In: AA.VV. Evoluzione e riforma dell’intervento pubblico. Scritti in onore di Gilberto Muraro. Torino: Giappichelli Editore, pp. 149-177.
  72. Rebba V., & Rizzi D. (2013). Ticket o franchigia? Considerazioni per una riforma delle compartecipazioni alla spesa sanitaria. Analisi e strumenti di politica sociale, 176.
  73. Roig-Tierno N., Gonzalez-Cruz T. F., & Llopis-Martinez J. (2017). An overview of qualitative comparative analysis: A bibliometric analysis. Journal of Innovation & Knowledge, 2(1): 15-23.
  74. Sala V., Moja L., Moschetti I., Bidoli S., Pistotti V., & Liberati A. (2006). Revisioni sistematiche-Breve guida all’uso. Centro Cochrane Italiano, 6.
  75. Salvatore D. (2004). I sistemi regionali di finanziamento corrente delle aziende sanitarie: un’analisi di quattro casi.
  76. Scarcella C., Indelicato A., Levaggi R., Lonati F., & Magoni M. (2007). Spesa sanitaria e invecchiamento della popolazione: il ruolo delle patologie croniche. Politiche sanitarie, 8(4): 177-187.
  77. Schabath M. B., & Cote M. L. (2019). Cancer progress and priorities: lung cancer. Cancer Epidemiology and Prevention Biomarkers, 28(10): 1563-1579.
  78. Schulz E., Leidl R., & König H. H. (2004). The impact of ageing on hospital care and long-term care ‒ the example of Germany. Health Policy, 67(1): 57-74.
  79. Shortell S. (1988). The evolution of hospital systems: Unfulfilled promises and self-fulfilling prophecies. Medical Care Review, 45(2): 177-214.
  80. Smoke T., & Smoking I. (2004). IARC monographs on the evaluation of carcinogenic risks to humans. IARC, Lyon, 1: 1-1452.
  81. Spillman B. C., & Lubitz J. (2000). The effect of longevity on spending for acute and long-term care. New England Journal of Medicine, 342(19): 1409-1415.
  82. Stearns S. C., & Norton E. C. (2004). Time to include time to death? The future of health care expenditure predictions. Health economics, 13(4): 315-327.
  83. Strandberg-Larsen M., & Krasnik A. (2008). Does a public single payer system deliver integrated care? A national survey study among professional stakeholders in Denmark. International Journal of Integrated Care, 8. -- Retrieved from http://www.ijic.org/index.php/ijic/article/view/248/494.
  84. Suter E., Oelke N., Adair C., & Armitage G. (2009). Ten key principles for successful health systems integration. Healthcare Quarterly, 13: 16-23.
  85. Tanoue L. T., Tanner N. T., Gould M. K., & Silvestri G. A. (2015). Lung cancer screening. American journal of respiratory and critical care medicine, 191(1): 19-33.
  86. Turoldo F. (2009). Bioetica ed etica della responsabilità. Dai fondamenti teorici alle applicazioni pratiche [Bioethics and Ethics of Responsibility. From Theoretical Foundations to Practical Applications] Assisi: Cittadella.
  87. WCRF/AICR (2007). World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective.
  88. Whitehead D. (2004). Health promotion and health education: advancing the concepts. Journal of advanced nursing, 47(3): 311-320.
  89. Wickstrøm J., Serup-Hansen N., & Kristiansen I. S. (2002). Future health care costs ‒ do health care costs during the last year of life matter?. Health policy, 62(2): 161-172.

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