I ticket sanitari: strumenti di controllo della domanda o artefici di disuguaglianze nell'accesso alle cure?

Co-payments (“tickets") are well-established tools for the control of healthcare demand in many Oecd countries, even though they are used with caution, and in combination with other instruments, to avoid potential negative impact on access to essential health care services. Usually public healthcare systems which do not employ co-payments, use waiting lists as an alternative rationing mechanism to cost sharing. This may be a worse solution to maximise wellbeing. This paper focuses on the use of co-payments as a direct instrument to control demand, analysing the implications of their use on efficiency and equity within a public healthcare system.