Questioni concernenti la nozione di costo standard: la mobilità dei pazienti e le mode sanitarie

The issues of patients’ interregional mobility and «health fashions» are, somehow, exemplary cases: they show that it is not possible tackling correctly financial issues (such as the financing of local public services or their standard cost) provided by the Enabling Act on Fiscal Federalism (5th May 2009, n. 42, providing the Delegation to the Government about Fiscal Federalism to implement Article 119 of the Italian Constitution), without firstly deciding who should get what, i.e. the issue of effectiveness. From the evidence collected and annotated in this study some policy indications turn out which could be useful for the implementation of the proposed Federalist Reform of the Italian State.