The course aims to provide the basic knowledge and the conceptual tools necessary to integrate the operation and interventions - from a comparative perspective - of the Italian health and social care system, with particular attention to its most recent evolution - which responds to demographic, socio-economic and political-institutional changes - and its future prospects. The fundamental concepts to study the health and social-health policies and the analysis of the historical-comparative evolution of the health and social-health systems will be introduced. The in-depth analysis of the main reforms will highlight the challenges to which policy-makers have had to respond, the political dynamics and the role of actors in the central and local "recalibration and reform" process of the health service and of the long-term assistance policies. The course takes into consideration health and in the social-health policies and intervention measures that also involve non-public actors.
Expected learning outcomes
At the end of the course the student will be able to use the acquired knowledge to critically frame the current policy choices and he/she will be able to demonstrate their relationship with the functioning of health and social-health systems, even when these choices have not been directly addressed during the lectures. The student will know how to describe the configuration and evolution of the Italian health and social-health system in a comparative perspective and he/she will know how to identify, for both areas of policy dealt, the main socio-demographic and economic challenges and the reform guidelines undertaken by Italy in the past , especially during the last decade.
Lesson period: Second trimester
(In case of multiple editions, please check the period, as it may vary)
The course aims to provide the basic knowledge and conceptual tools necessary to understand the functioning and evolution of the Italian health and social-health system in a comparative perspective, with particular attention to its most recent evolution (in response to demographic, socio-economic and political and institutional challenges), and future prospects. To this end, in the first part, the fundamental concepts for the study of health and social-health policies and the analysis of the historical-comparative evolution of health and social-health systems will be introduced. The second part of the course is devoted to the analysis of the main reforms in health and social-health policies and to the challenges that policy-makers had to face, focusing in particular on the political dynamics and the role of the actors in the process of recalibrating and reforming the health service both at central level and at regional level, and long-term care policies at national and local level. The course intends also to take into consideration policies and intervention involving non-public actors in the health and social-health sectors (such as supplementary healthcare measures).
More specifically, the lessons will focus on the following topics:
The welfare state: fundamental concepts and general framework Health policy: basic concepts and definitions Healthcare systems compared The historical evolution of health systems and new challenges From the introduction of the Italian NHS to the health reforms of the 1990s and 2000s Healthcare, fiscal federalism and regionalization
LTC policies: concepts and definitions The challenge of an aging population as a "new social risk" LTC models, measures and services compared The LTC system in Italy Innovating LTC policies: what role for public, private and local actors?
Prerequisites for admission
In order to better understand the content of this course, students should know the basic concepts of political science addressed in the first year course of Political and Administrative Systems.
Lessons; in-depth study and discussion in class of topics related to the course program; exercises.
Readings for the exam
F. Maino, La politica sanitaria italiana: origini, evoluzione e prospettive, Dispensa per il corso, 2020. F. Toth, Non solo Bismarck contro Beveridge: sette modelli di sistema sanitario, in «Rivista Italiana di Politiche Pubbliche», n. 2, 2016, pp. 279-305. F. Toth e R. Lizzi, Le trasformazioni «silenziose» delle politiche sanitarie in Italia e l'effetto catalizzatore della grande crisi finanziaria, in «Stato e Mercato», n. 2, 2019, pp. 297-320. E.M. Immergut, A. Roescu e B. Rönnerstrand, Innovative Governance and Health Reforms in Europe, in The Governance Report 2019, Oxford University Press, 2019. F. Maino e F. Razetti, Long Term Care: riflessioni e spunti dall'UE, fra innovazione e investimento sociale, in «La Rivista delle Politiche Sociali», n. 1, 2019, pp. 143-162. L. Crescentini, F. Maino e T. Tafaro, Non autosufficienza: analisi e proposte per un nuovo modello di tutela, Working Paper 2WEL 3/2018. I. Madama, F. Maino, F. Razetti, Innovating long-term care policy in Italy from the bottom: confronting the challenge of inclusive local care environments in Lombardy and Piedmont, in «Journal of Regional Research / Investigaciones Regionales», vol. 44, n. 2, 2019, pp. 125-141.
Additional materials - Slides will be made available on the course website and are part of the exam program. - During classes additional readings will be suggested to complete the program.
There are no differences in the program and in the exam readings between attending and non-attending students.
Assessement methods and criteria
The exam takes place in written form and includes open questions and some multiple choice tests, both aimed at ascertaining the acquisition of basic skills for the analysis of health and socio-health policies. One or more open questions will be aimed at verifying the ability to consciously and critically use the key concepts at the base of both policies covered during the course. Students who obtain a mark of at least 27/30 in the written test can request to take an oral exam, regarding all the topics covered in the course, to improve the final result of the exam. Taking the oral exam, however, does not necessarily lead to an improvement in the final mark. The exam aims to verify that students have learned the concepts and notions covered by the course, they know how to express them clearly (using the correct terminology), and they are capable of applying them to the analysis of new processes and case studies. Students can find information on the course and materials for exam preparation on the MOODLE platform. Students can have access from the CTU portal of UNIMI and register for this specific course website (more information will be provided in class).