Intergovernmental relations and Long Term Care reforms: lessons from the Italian case

Area of Science:

• Social Policy
• Public Administration
• Welfare Studies

Background:

• Italy's Long-Term Care (LTC) policies have undergone gradual transformation rather than comprehensive reform.
• Key interventions included regularizing migrant care work and automatic cash benefit increases.
• Existing LTC policies face challenges from policy fragmentation, universalistic benefits, and fiscal constraints.

Purpose of the Study:

• To analyze the reasons behind Italy's failure to reform Long-Term Care (LTC) policies.
• To investigate the overlooked interplay between LTC policies and intergovernmental multilevel relationships.
• To highlight the impact of federalism's legislative uncertainty on welfare innovation.

Main Methods:

• Qualitative analysis of Italian LTC policy development.
• Examination of intergovernmental relations and federal governance structures.
• Comparative analysis with existing literature on welfare reform.

Main Results:

• A weak and uncertain federalist framework significantly hindered LTC reform in Italy.
• Uncertainty in resource allocation and delayed equalization mechanisms exacerbated institutional fragmentation.
• The failure to fully implement federalist reforms impeded welfare innovations.

Conclusions:

• Successful welfare system institutional change requires careful consideration of federal governance and intergovernmental relations.
• Addressing challenges within federal structures is crucial for effective policy innovation in Long-Term Care.
• The Italian experience underscores the need for a robust federal framework to support welfare reforms.