Sommario:

1.Introduzione. 

2. Medical care triad e struttura di incentivi. 

3. I modelli organizzativi nella sanità e incentivi nella produzione. 

4. Cost-benefit della separazione tra finanziamento e produzione in sanità. 

5. Assicurazione sanitaria, sistemi di finanziamento e incentivi. 

6. Finanziamento e incentivi in un sistema di federalismo sanitario.

7. Sintesi e considerazioni conclusive. 

Abstract: 

The paper proposes a survey of health care organization and funding systems, aiming at underlining and discussing the role plaid by the incentives provided to the several economic agents involved (politicians, physicians, providers, insurance companies, etc.). Actually a national health service can be thought as a complex non-cooperative be game where the pay-off functions of the players are more or less divergent. The survey then examines the present features of various NHS, focusing on the efficiency and equity of public intervention and on the industrial organization of the institutional design of health care. In this context, it treats the rationale of cost-benefit of vertical integration of structures, devoted respectively to purchasing and providing health care services. Further, the paper deals with insurance systems, social as well private supplementary ones. The main distinctions of health care regimes in industrialised countries turn out to be not in terms of private versus public ownership of providers, rather in terms of industrial organization setting and in terms of incentives this provides to the agents.