In Lazio the key battle is the enormous public health system debt that involves the Angelucci clan and its Vatican allies that support the rightwing candidate. With the leftwing government of Piero Marrazzo they were able to get their way presumably through their knowledge of Marrazzo's sexual inclinations. If the Radical candidate Emma Bonino wins, this power group will likely be heavily penalized.
In Lombardy there is Milan Expo in 2012. Whoever runs the region will favour his own clans.
It boils down to sheer greed, corruption versus a modicum of honest governance.