Rich and well educated: are these requirements necessary to claim healthcare tax credits in Italy?

Background: The paper investigates the use of Healthcare Tax Credits (HTCs) in Italy through the analysis of a panel data which provides information on individual income tax from 2008 to 2014. Disparities emerging in the use of HTCs between Northern and Southern regions require to be analyzed. Objective: The aim of the paper consists in investigating the socioeconomic determinants in the use of Healthcare Tax Credits in Italy. Methods: A fixed effects Ordinary Least Square model is run to examine the impact of selected socioeconomic variables on regional per capita HTCs, with a particular focus on the role of education. Results: Findings corroborate the regressive traits of HTCs supported by literature and provide highlights on the role of education in explaining HTCs’ distribution among Italian regions. Conclusion: Public money is reimbursed to regions where people are on average richer and better educated. More equitable objectives could be reached by allocating the same resources in the provision of services covered by the NHS. Key points In Italy the use of HTCs, whose rationale is that of alleviating the fiscal burden for people who need healthcare access, turns out to be mostly regressive and to accentuate the Italian North South divide. HTCs represent a high amount of public money: in 2014 their value was 2.62 billion euros and represented 2.3% of the Public Health expenditure. Since this public money is reimbursed to finance prominently private healthcare access by the richest part of the population, it would be worth thinking of other measures to favor healthcare access by people in need of care.