Now this is an interesting perspective. If a region in Italy goes into health care deficit, then it has to raise local taxes to pay for it. Sort of makes sense, no? You spends it, you pays for it so to say. But the situation in England is different, we pay for the NHS out of country wide tax take. For example, we now have regional development agencies in England, which roughly correspond to the regions of NHS. Why dont we force them to look at local funding versus local taxes? Localisation is good. It will force local people to think more about their health. For example, the health figures for Scotland are bad, do you think if we force Scotland to raise money to cover the local health spend, that would make a difference?
It wont happen as there are quite a lot of issues with this, but as a general principle, closer the taxes and spend are, the better the management.