L’évolution de la gestion paritaire de la sécurité sociale en Belgique

The article exposes and analyses the evolution of the co-management of the social security system by employers and workers representatives in Belgium since they opted for a bismarckian model in 1944 until today. It gives an overview of the arguments of the debates that took place and explicative hypotheses. A vast management autonomy has been recognised to the social security bodies. But in the eighties, the Government did not restrain itself any longer to a mere control function and started taking decisions regarding the financial management. Thus, despite an evident continuity of the model, the evolution of the last twenty years is characterized by an increasing state intervention which leads to structural reforms officializing a kind of triparty global management and quadriparty management in public health insurance. Financing predominantly through social contributions was gradually reduced due to the diminishing of employer?s contributions.