A presente tese tem como objetivo analisar a modalidade de subsídio público à escola privada via mecanismo da dedução de despesas com instrução presente no IRPF (Lei nº 4.357/64), discutindo os argumentos favoráveis e contrários à sua permanência e/ou extinção, no contexto atual. Consideram-se despesas com instrução os gastos anuais referentes ao pagamento de matrículas, tanto do contribuinte quanto dos seus dependentes legais, na Educação Básica e o Ensino Superior. Durante muito tempo essa dedução foi considerada como sendo apenas um benefício tributário no campo do IRPF, sem outras implicações. Contudo, esse quadro é modificado a partir do momento em que tais benefícios passaram a ser considerados como gastos tributários (GTs). A ideia de gastos tributários trouxe à tona a problemática de que a partir do momento em que o Estado deixa de arrecadar um tributo, parcial ou integralmente, ele abre mão de uma determinada Receita Orçamentária em prol de objetivos específicos. O conjunto de benefícios integrante da função orçamentária educação indica que há uma quantia de aproximadamente 7,11 bilhões de Reais, no ano de 2012, (RFB, 2011) que se encontra, direta ou indiretamente, vinculada a instituições privadas/pagas de ensino. A dedução das despesas com instrução foi responsável pelo valor de mais três bilhões de Reais, constituindo-se no maior GT na área de Educação, originando uma série de questionamentos dentre os quais: Quando ela foi criada? De onde surgiu a ideia desta dedução? O que sua criação objetivava? Constituiu-se num assunto meramente tributário? Qual o vínculo com a educação e as políticas educacionais? Para responder a tais indagações, foi realizado um estudo detalhado sobre a dedução, constituído metodologicamente com base em pesquisa bibliográfica, pesquisa documental, análise de dados estatísticos e realização de entrevistas com especialistas na área tributária. O direito à educação e o financiamento apareceram como argumentos preponderantes: Tem-se direito à educação, o Estado não garante uma escola de qualidade (de acordo com conceitos coletivos e individuais) e por isso, este direito tem que ser garantido. Por outro lado, se o direito à educação é compreendido como fundamento de um processo abrangente, social e que se refere ao conjunto da população, tem-se que a dedução se encontra descompassada com as prerrogativas do Estado como provedor de uma educação com acesso igualitário e com qualidade minimamente padronizada (vide CAQ). Não se desconsidera a argumentação de que existam problemas relacionados às escolas públicas. Inclusive, o próprio PNE reconhece muitos desses problemas e demanda financiamento para que sejam sanados. Portanto, pontua-se a questão de se continuar financiando essas instituições privadas sob argumentos individuais ou direcionar a verba para que a educação pública supere preponderantemente os problemas elencados. Resumidamente, pode-se concluir que a dedução das despesas com instrução, apesar de ser comumente tratada como uma questão tributária, refere-se sobremaneira a questões educacionais. / The objective of this thesis is to study the modality of public subsidies to private schools through the education expenditure deduction present in IRPF (Act n. 4.357/64), by discussing the arguments in favor or against this deduction existence and/or extinction in current context. It is defined as expenditure with education: the annual expenditure regarding to the school fees, either for the tax payer or their legal dependents, in the basic and higher education. For a long time frame, this deduction has been regarded as being solely a tax benefit in the field of IRPF, without other implications. However, this reality is modified from the moment that such benefits started being regarded as tax expenditure (GTs). The idea of tax expenditure brought the discussion that from the moment the State is prevented from collecting taxes, partially or as fully, it gives up a given amount of budget revenues on behalf of some specific objectives. The overall objectives pertaining the budget function, education, shows that there is an approximate amount of 7,11 billion of Reais in 2012 (RBF, 2011) that is direct or indirectly bound to private/ or paid education provider institutions. The education deduction expenses claims the amount of three billion Reais, becoming the biggest GT in the field of education, which raises some questions, such as: When was it created? What was the source of this deduction idea? What did its creation target? Was it just a taxation issue? What is its linkage to education and education policies? To answer these questions, a detailed study on tax deduction was carried out, relying methodologically on bibliographical research, archival research, statistics data analysis and interviews with researchers on taxation issues. The right to education and the education funding are the keys theories on this study. One has the right to education, the state does not guarantee quality in education (in view of individual and collective concepts), thus one´s right has to be guaranteed. On the other hand, if the right to education is understood as the foundation of a broad and social process that is related to the whole population, it is believed that the deduction is mismatched with the State prerogatives as an guarantor of an equal access and a standardizes quality at it minimal levels education (vide CAQ). The discussion about the problems pertaining the public schools is not overlooked. PNE itself recognizes most of these problems and funding demands to address them. Therefore, the issue is whether the funding should continue to be addressed to these private institutions to address individual demands, or those funds should be addressed to public schools public education so that they overcome the problems identified. Summing up, it can be concluded that education expenditure deduction, though being commonly referred as a taxation issue, refers greatly to educational issues.

A presente tese tem como objetivo analisar a modalidade de subsídio público à escola privada via mecanismo da dedução de despesas com instrução presente no IRPF (Lei nº 4.357/64), discutindo os argumentos favoráveis e contrários à sua permanência e/ou extinção, no contexto atual. Consideram-se despesas com instrução os gastos anuais referentes ao pagamento de matrículas, tanto do contribuinte quanto dos seus dependentes legais, na Educação Básica e o Ensino Superior. Durante muito tempo essa dedução foi considerada como sendo apenas um benefício tributário no campo do IRPF, sem outras implicações. Contudo, esse quadro é modificado a partir do momento em que tais benefícios passaram a ser considerados como gastos tributários (GTs). A ideia de gastos tributários trouxe à tona a problemática de que a partir do momento em que o Estado deixa de arrecadar um tributo, parcial ou integralmente, ele abre mão de uma determinada Receita Orçamentária em prol de objetivos específicos. O conjunto de benefícios integrante da função orçamentária educação indica que há uma quantia de aproximadamente 7,11 bilhões de Reais, no ano de 2012, (RFB, 2011) que se encontra, direta ou indiretamente, vinculada a instituições privadas/pagas de ensino. A dedução das despesas com instrução foi responsável pelo valor de mais três bilhões de Reais, constituindo-se no maior GT na área de Educação, originando uma série de questionamentos dentre os quais: Quando ela foi criada? De onde surgiu a ideia desta dedução? O que sua criação objetivava? Constituiu-se num assunto meramente tributário? Qual o vínculo com a educação e as políticas educacionais? Para responder a tais indagações, foi realizado um estudo detalhado sobre a dedução, constituído metodologicamente com base em pesquisa bibliográfica, pesquisa documental, análise de dados estatísticos e realização de entrevistas com especialistas na área tributária. O direito à educação e o financiamento apareceram como argumentos preponderantes: Tem-se direito à educação, o Estado não garante uma escola de qualidade (de acordo com conceitos coletivos e individuais) e por isso, este direito tem que ser garantido. Por outro lado, se o direito à educação é compreendido como fundamento de um processo abrangente, social e que se refere ao conjunto da população, tem-se que a dedução se encontra descompassada com as prerrogativas do Estado como provedor de uma educação com acesso igualitário e com qualidade minimamente padronizada (vide CAQ). Não se desconsidera a argumentação de que existam problemas relacionados às escolas públicas. Inclusive, o próprio PNE reconhece muitos desses problemas e demanda financiamento para que sejam sanados. Portanto, pontua-se a questão de se continuar financiando essas instituições privadas sob argumentos individuais ou direcionar a verba para que a educação pública supere preponderantemente os problemas elencados. Resumidamente, pode-se concluir que a dedução das despesas com instrução, apesar de ser comumente tratada como uma questão tributária, refere-se sobremaneira a questões educacionais. / The objective of this thesis is to study the modality of public subsidies to private schools through the education expenditure deduction present in IRPF (Act n. 4.357/64), by discussing the arguments in favor or against this deduction existence and/or extinction in current context. It is defined as expenditure with education: the annual expenditure regarding to the school fees, either for the tax payer or their legal dependents, in the basic and higher education. For a long time frame, this deduction has been regarded as being solely a tax benefit in the field of IRPF, without other implications. However, this reality is modified from the moment that such benefits started being regarded as tax expenditure (GTs). The idea of tax expenditure brought the discussion that from the moment the State is prevented from collecting taxes, partially or as fully, it gives up a given amount of budget revenues on behalf of some specific objectives. The overall objectives pertaining the budget function, education, shows that there is an approximate amount of 7,11 billion of Reais in 2012 (RBF, 2011) that is direct or indirectly bound to private/ or paid education provider institutions. The education deduction expenses claims the amount of three billion Reais, becoming the biggest GT in the field of education, which raises some questions, such as: When was it created? What was the source of this deduction idea? What did its creation target? Was it just a taxation issue? What is its linkage to education and education policies? To answer these questions, a detailed study on tax deduction was carried out, relying methodologically on bibliographical research, archival research, statistics data analysis and interviews with researchers on taxation issues. The right to education and the education funding are the keys theories on this study. One has the right to education, the state does not guarantee quality in education (in view of individual and collective concepts), thus one´s right has to be guaranteed. On the other hand, if the right to education is understood as the foundation of a broad and social process that is related to the whole population, it is believed that the deduction is mismatched with the State prerogatives as an guarantor of an equal access and a standardizes quality at it minimal levels education (vide CAQ). The discussion about the problems pertaining the public schools is not overlooked. PNE itself recognizes most of these problems and funding demands to address them. Therefore, the issue is whether the funding should continue to be addressed to these private institutions to address individual demands, or those funds should be addressed to public schools public education so that they overcome the problems identified. Summing up, it can be concluded that education expenditure deduction, though being commonly referred as a taxation issue, refers greatly to educational issues.

Die Anwendung eines Mikrosimulationsmodells als Instrument der wirtschaftswissenschaftlichen Forschung erfreut sich großer Beliebtheit. Die Verwendung dieses Modelltyps hat vor allem zwei Gründe. Zum einen sind die in den letzten Jahren extrem gesunkenen Kosten der Informationsverarbeitung ursächlich für die mittlerweile häufige Verwendung. Zum anderen besitzt diese Analyseform Eigenschaften, die kein anderes Instrument aufweist. Insbesondere für die Abschätzung der Verteilungswirkungen von Steuer- und Transferreformen ist die Mikrosimulation eine nahezu ideale Methode. Durch die Einbindung eines Nachfragesystems kann sowohl das Anwendungsgebiet eines Mikrosimulationsmodells erweitert als auch dessen potentielle Leistungsfähigkeit gesteigert werden. Die Arbeit hat im Wesentlichen die Beantwortung der Fragestellungen aus den folgenden zwei Fragenkomplexen zum Ziel: - Wann ist die Einbindung eines Nachfragesystems in Mikrosimulationsmodelle sinnvoll und wie kann ein solches System in das eigentliche Mikrosimulationsmodell integriert werden? - Welche Nachfragesysteme können aus den in Deutschland in Querschnittsform vorhandenen Mikrodatensätzen geschätzt werden und welche theoretischen Eigenschaften besitzen diese Systeme bzw. deren in einem zweistufigen Budgetierungsprozess einsetzbare Kombinationen? / The application of a microsimulation model as an instrument for economic research enjoys great popularity. The use of this type of model primarily has two reasons. In the first place the decreasing costs of data processing led to the frequent usage. Furthermore this type of analysis has unique characteristics compared to other instruments. Particularly microsimulation is an almost ideal method for the estimation of the impact of tax and allocative transfer reforms. With the integration of a demand system the field of application of a microsimulation model can be enlarged as well as its potential capacity increased. This paper has the aim to answer basically two batteries of questions: - In what case the integration of a demand system in a microsimulation model is reasonable and how can such a system be integrated in the model? - Which demand systems can be estimated from the microdata available in Germany and which characteristic properties do such systems offer, especially the combinations applicable in a two-stage budgeting environment?

Purpose: The purpose of this study was to investigate if there was any difference in energy expenditure (kcal/min) and oxygen consumption (VO2) between subjects walking with Masai Barefoot Technology ® (MBT) shoes and regular orthopedic shoes. The research hypothesis was that MBT shoes demand more energy expenditure than regular orthopedic shoes. Methods: Seven women aged 49-65 were recruited for the study. The subjects were tested in two sessions, with a minimum of two weeks in between each sesssion. On each test session the subjects walked with both MBT shoes and orthopedic shoes which were adjusted in mass (g) to match the mass of the MBT shoes. While the subjects walked on a treadmill, the oxygen consumption (VO2), heart rate (min-1) and self selected velocity (m/s) for each of the shoe types was measured. Results: Results showed that there is no significant difference in oxygen consumption (VO2) between the MBT and orthopedic shoes. Energy expenditure (kcal/min) was also calculated from the data and the results revealed that there is no significant differ-ence between MBT and orthopedic shoes in energy expenditure (kcal/min) either. The self selected velocity (m/s) between the two shoe types was also found to be insignificant. Conclusion: The results showed no significant difference between the shoes. This could indicate that the specific construction of the MBT shoe has no effect on the energy expenditure (kcal/min) of its user. This lack of difference may be due to the equal mass of the shoes, but since oxygen consumption (VO2) was not investigated in orthopedic shoes with different shoe masses, this conclusion cannot be confirmed. The self selected velocity (m/s) was found to be insignificant and this finding could suggest to that prolonged usage of the MBT shoe may diminish gait parameters dissimilarities during ambulation. This study should therefore be seen as a pilot study and further investigation in this area should be pursued.

This thesis will discuss the role of government in venture capital market and illustrate the national difference of that through a comparative study of government expenditure supporting policies of venture capital investment in the USA, Canada and China. Firstly, the prototype programs designed by Small Business Administration (SBA) of the United States and Canadian policies by the Business Development Bank of Canada (BDC) will be discussed. Secondly, the current Chinese government expenditure supporting policies will then be studied in the context of the Chinese venture capital market’s unique political, economical and legislative background. Ultimately, potential improvements in the future expenditure incentive programs in China will be explored.

This thesis will discuss the role of government in venture capital market and illustrate the national difference of that through a comparative study of government expenditure supporting policies of venture capital investment in the USA, Canada and China. Firstly, the prototype programs designed by Small Business Administration (SBA) of the United States and Canadian policies by the Business Development Bank of Canada (BDC) will be discussed. Secondly, the current Chinese government expenditure supporting policies will then be studied in the context of the Chinese venture capital market’s unique political, economical and legislative background. Ultimately, potential improvements in the future expenditure incentive programs in China will be explored.

Τα ΑΕΕ είναι η πρώτη αιτία αναπηρίας και η τρίτη αιτία θανάτου παγκοσμίως. Επίσης οι ασθενείς με ΑΕΕ είναι οι συχνότεροι χρήστες των υπηρεσιών υγείας. Παράλληλα, στη χώρα μας δαπανάται ετησίως το 10% του Ακαθάριστου Εγχώριου Προϊόντος (ΑΕΠ) για την υγεία σε σχέση με το μέσο όρο του 8,9% των χωρών του Οργανισμού Οικονομικής Συνεργασίας και Ανάπτυξης (ΟΟΣΑ). Στόχος της μελέτης είναι η οικονομική αξιολόγηση του ενδο-νοσοκομειακού κόστους ασθενών με οξύ ΑΕΕ στην Ελλάδα καθώς επίσης και ο προσδιορισμός ανεξάρτητων παραγόντων που επηρεάζουν το κόστος νοσηλείας. Καταγράφηκαν δημογραφικά και κλινικά χαρακτηριστικά σε 429 συνεχόμενους ασθενείς με οξύ ΑΕΕ (ισχαιμικό ή αιμορραγικό) που εισήχθησαν σε όλες τις κλινικές του Πανεπιστημιακού Γενικού Νοσοκομείου Πατρών για διάστημα 18 μηνών. Υπολογίσαμε το κόστος, για κάθε ασθενή ατομικά, από την ώρα της εισβολής του ΑΕΕ έως την έξοδό του από το νοσοκομείο. Το κόστος μετρήθηκε σε ευρώ (€) και σύμφωνα με τις πραγματικές δαπάνες του νοσοκομείου. Η μέση ηλικία των ασθενών ήταν 68.9 (±12.7) έτη και η διάρκεια νοσηλείας ήταν 10.9 (±7.9) ημέρες. Οι 345 ασθενείς (80%) είχαν ισχαιμικό ΑΕΕ και 84 (20%) είχαν πρωτοπαθή ενδοεγκεφαλική αιμορραγία. Το άμεσο ενδο-νοσοκομειακό κόστος νοσηλείας όλων των ασθενών με οξύ ΑΕΕ ανήλθε στα 1.551.445,00 € για μια συνολική διάρκεια νοσηλείας 4.674 ημερών (331,9 € ανά ημέρα νοσηλείας). Το μέσο ενδονοσοκομειακό κόστος ανά ασθενή με ΑΕΕ ήταν 3.624,9(±2695.4) €. Το 59% του συνολικού κόστους αποδόθηκε στο κόστος "κλίνης και προσωπικού", (6%) "προ εισαγωγής", (13%) "εργαστηριακό έλεγχο", (6%) "απεικονιστικό έλεγχο", (8%) "αποκλειστική νοσηλευτική φροντίδα", (7%) "φαρμακευτική αγωγή", (0.6%) "θεραπεία αποκατάστασης" και (0.7%) "διάφορα έξοδα". Τα αιμορραγικά ΑΕΕ είχαν σημαντικά μεγαλύτερο κόστος από τα ισχαιμικά ΑΕΕ (μέσο 5305.4 και 3.214,5 €, αντίστοιχα). Μεταξύ των υπότυπων των ισχαιμικών ΑΕΕ το συνολικό μέσο κόστος ήταν σημαντικά χαμηλότερο για τα "κενοτοπιώδη" έμφρακτα (2328.7±1100.2 €). Η διάρκεια νοσηλείας είχε υψηλή συσχέτιση με το συνολικό ενδο-νοσοκομειακό κόστος. Η πολυπαραγοντική γραμμική ανάλυση παλινδρόμησης έδειξε ότι το τμήμα εισαγωγής, η βαρύτητα του ΑΕΕ στην εισαγωγή, ο τύπος του ΑΕΕ και η κατάσταση εξόδου ήταν ανεξάρτητοι παράγοντες του κόστους. Αν επιθυμούμε τη συγκράτηση του νοσοκομειακού κόστους, θα πρέπει να ληφθούν υπόψη πολιτικές διοίκησης που στοχεύουν στη μείωση της διάρκειας νοσηλείας. / Stroke is the first cause of disability and the third cause of death worldwide. Moreover, in the western countries, the stroke patients are the most frequent users of all the health services and the hospital budgets. At the same time, 10% of the Gross Domestic Product (GDP) is annually spent on health in relation with the average 8.9% of the Organisation for Economic Co-operation and Development (OECD) countries. Aim of this study is the economic evaluation on the in-hospital cost of patients with an acute stroke in Greece and the identification of potential independent factors influencing this cost. Demographic and clinical data were recorded on 429 consecutive patients with an acute stroke (ischemic and hemorrhagic), admitted to the University General Hospital of Patras during a period of 18 months. We calculated the cost, individually for each patient, from the stroke onset until the discharge from the hospital. The cost was measured in euro (€), according to the real expenditure of hospital. Mean age was 68.9 (±12.7) years and length of stay (LOS) was 10.9 (±7.9) days. In all, 345 patients (80%) had an ischemic stroke and 84 (20%) had a primary intracerebral hemorrhage. The direct in-hospital cost of all stroke patients, 1.551.445,00 €, accounted for a total hospitalisation of 4.674 days (331.9 € per day in hospital). The mean in-hospital cost per patient was 3.624,9 (±2695.4) €. The 59% of the total cost concerns the cost of "bed and staff", (6%) "pre-hospital cost", (13%) "laboratory investigations", (6%) "imaging investigations", (8%) "supportive nursing", (7%) "medication", (0.6%) "rehabilitation therapy" and (0.7%) "other expenses". Hemorrhagic strokes were significantly more expensive than the ischemic strokes (mean 5305.4 (± 4204.8) € and 3214,5 (±1976.2) € respectively). Amongst ischemic stroke subtypes the mean total cost was significantly lower for lacunar strokes (2328.7 ± 1100.2 €). The length of stay was highly correlated with in-hospital total cost. Multivariate linear regression model showed that the admission ward, stroke severity on admission, stroke type and status discharge were independent predictors of cost. In order to withhold the hospital cost, policies of administration that aiming to the reduction of length of stay should be taken into consideration.

1980年代以來，國家競爭力的概念漸受重視，提升國家競爭力成為各國政府主要的施政目標。雖然國家競爭力因具有一定的重要性而被各界所接受，但時至今日仍缺乏對其共通之定義及衡量方法。本文係以目前最具公信力的衡量機構，即瑞士洛桑國際管理學院 (IMD) 與世界經濟論壇 (WEF) 所做的國家競爭力研究報告加以探討。 本研究以政府活動的內生成長模型為理論基礎，由政府支出面來探討其與國家競爭力的關係及影響國家競爭力的程度。經由具有公信力的國家競爭力評比中，選取具有比較性的國家，研究其支出結構的變動對其競爭力排名是否造成影響。本研究結果，主要發現，一般公共服務及公共秩序支出比重，對國家競爭力的提升有所幫助，但並非具有絕對正向關係；教育支出比重較高，對國家競爭力的提升具有正面效果；保健支出比重及經濟支出比重無法直接影響國家競爭力相關細項指標；政府投入適度的社福支出，對整體社會的穩定有所幫助。並提出可參採建議為，預算支出結構並無各國一體適用的最佳配置，應尋求符合國家整體最大利益的配置方式；參考先進國家預算支出結構，適當調整我國各項職能所占比重；知識經濟時代，宜由增加教育投資，提升國家整體人力素質；今後國家的發展，宜注意各項預算支出對國家競爭力實際可能產生的影響；政府各部門宜重視公共支出如何配合施政目標，以提升政府效率。 / Since the 1980s, the concept of national competitiveness has gradually gained attentions, and how to enhance national competitiveness becomes a major goal for the governments. Although this concept has been widely accepted because of its importance, until today there doesn’t have common definitions and measurements against the competitiveness. This paper is produced by exploration of the reports in regards to the competitiveness of countries of the world which were generated by the most credible unions, the International Institute for Management Development in Switzerland (IMD) and the World Economic Forum (WEF). This paper researches, with references to endogenous growth theory, the relationships between the government expenditures and country’s competitiveness. Through the credible comparability assessments, this paper selects major countries to research how the expenditure structures influence the national competitiveness. The important conclusion from this research tells that it’s not always positive correlation between the weighting of government’s general public services expenditure and the improvement of country’s competitiveness, though general public services expenditure is helpful for competitiveness. Education expenditure does positively affect the competitiveness. The weighting of health expenditure and economic affairs expenditure can’t affect relevant competitiveness indicators. Appropriate social welfare from government helps for the stabilization of the society. This research suggests there is no best budget structure fits in with all countries, governments need to assess respective budget allocation approach to maximize the interests for the country. Governments can refer to developed countries for their budget structure in relevant areas to adjust own budget allocation. In the era of knowledge centric economy, governments should lift manpower quality by allocation of more resources in education. In view of country’s development in the future, governments should be aware how budget structure can affect country’s competitiveness. All departments of the government should care how public expenditure can support country’s goals in order to enhance government performance.

La recherche se propose d’analyser la soutenabilité de la dépense publique avec un approfondissement qui concerne le cas italien et en prenant le système de la Santé publique comme référence empirique. La première partie en reprenant les idées de caractère macroéconomique, présente une brève vue générale sur le thème de la soutenabilité de la dette publique et sur les critiques principales aux normes du Traité de Maastricht. Après avoir introduit le thème des comptes publics en les encadrant dans le plus large plan conceptuel du Traité de Maastricht et de normes qui le concernent, l’attention a été focalisé sur le nouveau plan de governance européenne, qui s’est précisé après la crise économique-financière en 2007, et sur le thème des statistiques et de leur modalité de construction. La deuxième partie fait ses principales définitions de soutenabilité spécifiquement référées au contexte de la santé publique, et propose le cas de la dépense sanitaire en Italie avec l’introduction des Plans de Restructuration (PdR) finalisés au déplacement des déterminants structurales du déséquilibre des Systèmes Régionales de la Santé (SSR) intéressés. / The objective of this thesis is to explore the theme of sustainability of public debt and public expenditure with an empirical focus on the Italian healthcare expenditure. Starting from a literature review, this work shows that sustainability have not an univocal and widely accepted definition and that macro economical point of view tend to prevail. At the same time the recent tension on public debt in European countries has highlighted the need of harmonized accountability systems capable to show the real level of public debt and public expenditure. The Italian healthcare system has represented a very interesting case to explore the effect of the implementation of an accrual system of accountability and the sustainability of public expenditure by the implementation of Healthcare recovery plan. This empirical analysis has been implemented by the use of a case study methodology. Results show that healthcare turnaround plan do not contain valid instrument of sustainability. / L'obiettivo di questa tesi è quello di esplorare il tema della sostenibilità del debito pubblico e della spesa pubblica con un focus empirico sulla spesa sanitaria italiana. Partendo da una review della letteratura, questo lavoro dimostra che il concetto di sostenibilità non ha una definizione univoca e ampiamente accettata. Allo stesso tempo, le recenti tensioni sul debito pubblico nei paesi europei ha evidenziato la necessità di sistemi di contabilità armonizzati e capaci di mostrare il reale livello del debito pubblico e della spesa pubblica. Il sistema sanitario italiano ha rappresentato un caso molto interessante per esplorare gli effetti di un sistema di contabilità pubblica incentrato sul principio della competenza economica e, soprattutto, per testarne - nella pratica - le conseguenze sul livello della spesa sanitaria. In particolare, l'ultima parte di questo lavoro pone l'attenzione sul tema dei piani di rientro della spesa sanitaria italiana. L'analisi empirica, realizzata attraverso il metodo dello studio di casi multipli, mostra come i piani di rientro, nella loro attuale configurazione, non possano essere considerati validi strumenti non solo per il contenimento della spesa sanitaria e il rientro dal disavanzo ma, soprattutto, che non possono essere considerati strumenti operativi validi nell'ottica della sostenibilità.

Magister Legum - LLM / Directors of companies are the forerunners in overseeing and strategically managing a company.1 The Companies Act 71 of 2008 (the Companies Act) gives the board of directors the legislative obligation for a company to be managed by or under the direction of the board of directors.2 The board of directors have a central role in the decision making and operation of a company; this position also applies to the board of directors of State owned Companies (SOC). This dissertation explores methods to hold directors of SOCs personally liable for irregular, wasteful and fruitless expenditure Irregular expenditure is defined as expenditure that does not comply with the provisions of the Public Finance Management Act 1 of 1999 (PFMA), the State Tender Board Act 86 of 1968 or any legislation that provides for provincial government procedure.3 Fruitless and wasteful expenditure is defined as ‘expenditure which was made in vain and would have been avoided had reasonable care has been exercised’.This research aims to analyse legislative mechanisms put in place that hold directors of SOCs personally liable for irregular, reckless, wasteful and fruitless expenditure. Section 77(2)(b) and 218(2) of the Companies Act contains the legislative basis for the personal liability of directors of SOCs for irregular, wasteful and fruitless expenditure.