This paper is aimed at analysing the key issues of the process of medical malpractice risk allocation in the Italian public health system. First, we discuss the role of liability as an efficient mechanism which is planned to incentivate optimal levels of (unobservable) care. We then introduce the function of liability insurance and we argue that the opportunity to transfer the liability risk on the insurance market could dilute the before mentioned optimal incentives, unless the coverage is adequately designed. We then turn to the empirical section of the work which is focused on the Italian case. In particular, we have built a large database which includes all the information contained in 308 tender notices concerning the acquisition of RCT/O coverage by the Italian local public health firms. Our database is composed by all those notices which have been published on the Official Journal of the European Union between 2003 and 2006. The analysis of the data collected provides a first assessment of i) the ability of the Italian public sector to find risk coverage on the private insurance market, ii) the dynamics of prices and market power of insurance firms, and iii) the role of insurance brokers. The results highlight a structural discontinuity at the end of 2004; the last two years of our sample are characterized by a reduced frequency of failed tender, a significant increase of the premiums collected and a higher participation of brokers. We propose two alternative scenarios which explain the proposed empirical evidence.
|Titolo:||Meccanismi allocativi per il rischio sanitario nelle aziende sanitarie pubbliche italiane|
|Data di pubblicazione:||2008|
|Appare nelle tipologie:||1.1 Articolo in rivista|