The third age in the national health system: a proposal for increasing the spending effectiveness in health care for the elderly

The allocation among Institutional Sectors of Health Care Expenditure for the Elderly can be designed in a way that new processes can be activated that stimulate total output and overall employment. The impacts of these processes as they emerge from several policy scenarios in all phases of income circular flow within the economic system, can be determined with reference to the model of computable general equilibrium (CGE) calibrated on the Social Accounting Matrix (SAM) data set. The HCEE is placed within the economic flows of a bi-regional SAM for Italian economy which provides the data set for a CGE model where the hypothesis of involuntary unemployment is also considered. Two policy scenarios are then simulated to evaluate the impact of the policy reform in HCEE on total output and unemployment. Under the first scenario the Regional Government reduces the expenditure in integrated home care assistance (ADI) in order to directly increase the demand of private residential health care (ARA) services; under the second scenario the Regional Government transfers the resources saved by reducing ADI to the Households in order to stimulate their demand of ARA.