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Health spending in Italy: the impact of immigrants

Author

Listed:
  • Giulia Bettin

    (Department of Economics and Social Sciences, Universita' Politecnica delle Marche)

  • Agnese Sacchi

    (Department of Economics and Law, Sapienza University)

Abstract
The welfare impact of immigration is a hot topic especially for countries at the external borders of the European Union. This paper studies how immigrants affect public health expenditure across Italian regions during the period 2003-2015. Identification strategy is based on shift{share instruments, which are also robust to pull factors that might attract immigrants in Italy and to internal migration of natives. We find that a 1 percentage point increase in immigrants over total population leads to a decrease in public health expenditure per capita by about 3.9% (i.e. around 70 euro per capita). This evidence is confirmed when focusing on needy immigrants from low income countries with less developed welfare systems. Among possible channels, we find no support for any crowding out effects from public to private health services by natives due to increasing immigration neither for the effect of entry barriers limiting the immigrants' reliance on public healthcare. Our results are driven by immigrants' demographic structure: foreigners are mostly males and younger workers that call for less health spending, according to a positive selection mechanism.

Suggested Citation

  • Giulia Bettin & Agnese Sacchi, 2019. "Health spending in Italy: the impact of immigrants," Working Papers 433, Universita' Politecnica delle Marche (I), Dipartimento di Scienze Economiche e Sociali.
    • Handle: RePEc:anc:wpaper:433
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    1. Sorpresa: più immigrati, meno spesa sanitaria
      by Giulia Bettin e Agnese Sacchi in La Voce on 2019-02-12 09:37:18

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    1. D'Andreamatteo, Antonio & Neri, Francesca & Antonucci, Gianluca & Sargiacomo, Massimo, 2024. "Immigration, policies of integration and healthcare expenditure: A longitudinal analysis of the INHS (2002‒2018)," Health Policy, Elsevier, vol. 142(C).
    2. Caravaggio, Nicola & Resce, Giuliano, 2023. "Enhancing Healthcare Cost Forecasting: A Machine Learning Model for Resource Allocation in Heterogeneous Regions," Economics & Statistics Discussion Papers esdp23090, University of Molise, Department of Economics.
    3. Giulia Bettin, 2019. "Il valore economico dell?immigrazione," PRISMA Economia - Societ? - Lavoro, FrancoAngeli Editore, vol. 2019(2), pages 12-30.

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    13. Anna Maria Mayda & Mine Z. Senses & Walter Steingress, 2023. "Immigration and Provision of Public Goods: Evidence at the Local Level in the U.S," Staff Working Papers 23-57, Bank of Canada.
    14. Mark Colas & Dominik Sachs, 2020. "The Indirect Fiscal Benefits of Low-Skilled Immigration," CESifo Working Paper Series 8604, CESifo.
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    More about this item

    Keywords

    immigration; public health expenditure; demographic structure; positive selection;
    All these keywords.

    JEL classification:

    • F22 - International Economics - - International Factor Movements and International Business - - - International Migration
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H41 - Public Economics - - Publicly Provided Goods - - - Public Goods
    • I10 - Health, Education, and Welfare - - Health - - - General
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

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