Healthcare Policies and Social and Health Services

A.Y. 2024/2025
6
Max ECTS
40
Overall hours
SSD
SPS/04
Language
Italian
Learning objectives
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 connection 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 reforms undertaken by Italy especially during the last three decades.
Single course

This course can be attended as a single course.

Course syllabus and organization

Single session

Responsible
Lesson period
Second trimester
Course syllabus
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 from a comparative perspective, with particular attention to its most recent development (in response to demographic, socio-economic, and political, and institutional challenges), and prospects. To this end, the fundamental concepts for studying health and social-health policies and analyzing the historical-comparative evolution of health and social-health systems will be introduced. Moreover and concerning the last three decades, 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 the health service both at the central level and at the regional level, and long-term care policies at the national and local level. The course also intends to consider policies and interventions 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
- Brief historical evolution of health systems and new eco-social challenges
- From the introduction of the Italian NHS to the health reforms of the 1990s and 2000s
- Healthcare, fiscal federalism, and regionalization
- The Italian NHS and the challenge of PNRR.

- 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 and the challenge of PNRR: toward a national reform
- Innovating LTC policies: what role for the 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.
Teaching methods
Lessons; in-depth study and discussion in class of topics related to the course program; exercises.
Teaching Resources
Readings for the exam

- F. Maino e F. Razetti, La conquista e le sfide: qualità e accessibilità del servizio sanitario universale, in R. Leonardi e R. Nanetti (a cura di), Il grande albero e le sue radici diffuse in Europa: le Regioni italiane a cinquant'anni, Presidenza del Consiglio dei Ministri, Roma, 2022 [disponibile su Moodle]
- F. Toth, Non solo Bismarck contro Beveridge: sette modelli di sistema sanitario, in «Rivista Italiana di Politiche Pubbliche», n. 2, 2016, pp. 279-305 [riviste online UNIMI]
- 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 [riviste online UNIMI]
- S. Neri, Il Servizio Sanitario Nazionale e la riforma dell'assistenza territoriale: tra collasso e rilancio, in «Autonomie locali e servizi sociali», n. 1, 2023, pp. 2-17 [riviste online UNIMI]
- G. Vicarelli, L'universalismo in sanità a 45 anni dalla istituzione del Ssn, in «Politiche Sociali», n. 3, 2023, pp. 405-424 [riviste online UNIMI]
- F. Maino e C.V. De Tommaso, Gli anziani fragili, in F. Longo e F. Maino (a cura di), Platform Welfare. Nuove logiche per innovare i servizi locali, Milano, Egea, 2021, pp. 165-190 [disponibile su Moodle]
- F. Maino e F. Razetti, Superare l'immobilismo: alla ricerca dell'innovazione nelle politiche di LTC, in «Biblioteca della libertà», LV, n. 229, 2020, pp. 67-100 [disponibile su Moodle]
- M. Betti e F. Maino, Una tipologia di anticipatory governance per la transizione digitale nei sistemi sociosanitari. Evidenze da Lombardia e Toscan, in «Politiche Sociali», n. 2, 2023, pp. 245-268 [riviste online UNIMI]
- C. Gori, La riforma dell'assistenza agli anziani non autosufficienti, in «Politiche Sociali», n. 3, 2023, pp. 511-516 [riviste online UNIMI]
- C.V. De Tommaso e F. Maino, La Legge 33/2023 di riforma dell'assistenza a lungo termine in Italia tra policy e politics: oltre l'immobilismo, un'opportunità di riforma?, in L. Gui e A. Salvati (a cura di), Il welfare di fronte alle sfide globali: sostenibilità, coprogettazione, innovazione, FrancoAngeli, 2024 [disponibile su Moodle]

Additional materials
- Slides will be 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 exam readings between attending and non-attending students.
Assessment methods and Criteria
The exam takes place in written form during the first test (scheduled in the second half of March 2025) and in oral form for the rest of the tests. It aimed at ascertaining the acquisition of basic skills for analyzing health and socio-health policies. One or more questions will verify the ability to consciously and critically use the key concepts at the base of both policies covered during the course.
The exam aims to verify that students have learned the concepts and notions covered by the course, know how to express them clearly (using the correct terminology), and can apply them to the analysis of new processes and case studies.
Students can find information on the syllabus and materials for exam preparation on the MOODLE platform by registering for this specific course at the CTU portal of UNIMI.
More information will be provided during classes.
SPS/04 - POLITICAL SCIENCE - University credits: 6
Lessons: 40 hours
Professor: Maino Franca
Shifts:
Turno
Professor: Maino Franca
Professor(s)
Reception:
From January to Mid-March: Monday from 10.00 to 13.00. During the rest of the year: Monday from 14.00 to 17.00. I am available by appointment. I can be contacted by e-mail and MS Teams.
Department of Social and Political Sciences, Room no. 17, second floor