Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization.

Fiscal Federalism 2022 surveys recent trends and policies in intergovernmental fiscal relations and subnational government. Accessible and easy-to-read chapters provide insight into: good practices in fiscal federalism; the design of fiscal equalisation systems; measuring subnational tax and spending autonomy; promoting public sector performance across levels of government; digitalisation challenges and opportunities; the role of subnational accounting and insolvency frameworks; funding and financing of local government public investment; and early lessons from the COVID-19 crisis for intergovernmental fiscal relations.

This book deals with two issues. The first concerns the various measurement of fiscal decentralization in general and their usefulness for policy analysis. The second and more specific issue concerns the taxonomy of intergovernmental grants and the limits of the current classifications.

This book explores the dynamics of health system decentralization and recentralization, investigating why and how the territorial organization of health systems changes or remains stable over time. Drawing from historical and discursive institutionalism, the explanatory framework revolves around the role of ideas, discourse and institutions. Through the analysis of the Italian and Danish health systems, the book corroborates the value of combining ideational and institutional accounts in explaining institutional continuity and change, offering new empirical and theoretical insights into the study of public policy making. The book will be of use to students and scholars interested in health politics and policy, federalism and decentralization, and theories of institutional change.

This book draws on experiences in developing countries to bridge the gap between the conventional textbook treatment of fiscal decentralization and the actual practice of subnational government finance. The extensive literature about the theory and practice is surveyed and longstanding problems and new questions are addressed. It focuses on the key choices that must be made in decentralizing, on how economic and political factors shape the choices that countries make, and on how, by paying more attention to the need for a more comprehensive approach and the critical connections between different components of decentralization reform, everyone involved might get more for their money.

This is the first book to examine the processes of territorial federalization and decentralization of health systems in Europe drawing from an interdisciplinary economics, public policy and political science approach. It contains key theoretical and empirical features that allow an understanding of when health care decentralization is successful.