Federalism and Health Care: A Comparative Policy Analysis of Canada and Italy

Canada and Italy do not share many of the features associated with modern welfare state development, yet both countries have experienced changes in the way health care programs are administered and funded, and in the shift in fiscal responsibility between center and sub-national governments. This article explores the relationship between federalism, decentralization and health reform in Canada and Italy. It investigates how the two countries–one federal, the other “regionalized”–have designed and adapted their health care systems to respond to similar issues of equity, cost containment and organization.