The Italian Governance of Interregional Healthcare Mobility between Fiscal Federalism and Budgetary Restrictions

The paper aims at exploring the issue of THE GOVERNANCE AND FINANCING OF INTERREGIONAL HEALTHCARE MOBILITY IN ITALY after the start of the reform for the Implementation of Fiscal Federalism and in the light of the budgetary restrictions imposed by the Spending Review and the Internal Stability Pact. From this particular point of view, this topic is closely connected with the issue of THE ROLE OF HEALTHCARE SYSTEMS, AND INSTITUTIONS IN GENERAL, IN TACKLING INEQUALITIES AND POVERTY and with the study of THE DISTRIBUTIONAL ASPECTS OF HEALTH POLICIES AND MEDICINE, which brings advantage especially to the rich and powerful people of the Earth, because today, evidently, medicine and healthcare are distorted, reshaped in the interests of these individuals (see I. Heath, "Contro il mercato della salute, Bollati Boringhieri, Torino, 2016). The legal institutions, in fact, and the healthcare systems, among them, very often nourish and reinforce inequality within society rather than reduce it, so that inequality has become systematic, favored also, rather than counteracted, by policies that tolerate or actually enforce unfair distribution of and access to power, wealth, and other necessary social resources. The legal institutions and the healthcare systems, on the contrary, should be considered by governments as the ideal platform to openly fight poverty and promote equity, because the ways in which healthcare institutions dealing with the most vulnerable part of the population represents an index of how society sees itself: if these institutions tolerate a health service that excludes certain categories of people, consequently they legitimize social exclusion and accept the unavoidability of social inequalities. Starting from this opinion, further developing an analysis carried out in 2009 on the issue of patient mobility, the paper tries to show how the manner in which the Italian healthcare institutions dealing with this problem indicates how much respect they address to the needs of the people living in the weakest part of the country, namely in the South of Italy (the so-called Mezzogiorno)