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Les dépenses de santé des Français : une maladie d'amour?

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  • Bruno Ventelou

Abstract

[eng] Health care expenditures in France : ailments of love ? Bruno Ventelou In France, health care expenditures increase faster than GDP, which is a recurrent dilemma for the public finance balance of the social protection system. Microeconomic analysis identifies several reasons for such an evolution, linked to informational problems (informational asymmetries between the patient, the physician and the insurance). Microeconomic also provides a large array of incentives and mechanism designs in case of informational asymmetries, and then, inclines in favour of « structural reforms » in order to obtain an efficient health system. Comparative study of health care systems abroad shows that France is not isolated with regard to its difficulties in controlling health expenditures. Nevertheless, economists could be surprised by the reforms implemented in France : they tend to be more oriented toward a (short term) quantitative rationing mechanism rather than toward a (long term) qua- litative and structural response to the existing deficiencies of the health care sector. JEL codes : I10, I11, I18 [fre] Les dépenses de santé des Français croissent plus vite que le PIB, ce qui ne manque pas de poser un problème, manifeste au terme de chaque année budgétaire, à l'équilibre comptable du système de protection sociale. L'analyse microéconomique identifie de multiples raisons à la dérive des dépenses, liées principalement à des lacunes informationnelles entre les acteurs de la relation médicale (le patient, le soignant et l'assureur maladie) : elle plaide pour des réformes structurelles, attentives aux incitations économiques effectivement fournies par le système de santé. L'examen comparé des systèmes de santé étrangers montre que la France ne fait pas exception pour ses difficultés de contrôle de l'évolution de la dépense de santé. Cependant, on peut s'interroger sur la logique des réformes qui ont été appliquées ou qui sont proposée actuellement : elles s'avèrent orientées bien plus vers des mesures de contingentement quantitatif et de contrôle a posteriori que vers la recherche des mutations qualitatives internes au secteur et nécessaires à son bon fonctionnement.

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File URL: http://dx.doi.org/10.3406/ofce.1999.1560
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File URL: http://www.persee.fr/articleAsPDF/ofce_0751-6614_1999_num_71_1_1560/ofce_0751-6614_1999_num_71_1_1560.pdf?mode=light
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Bibliographic Info

Article provided by Programme National Persée in its journal Revue de l'OFCE.

Volume (Year): 71 (1999)
Issue (Month): 1 ()
Pages: 247-280

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Handle: RePEc:prs:rvofce:ofce_0751-6614_1999_num_71_1_1560

Note: DOI:10.3406/ofce.1999.1560
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Web page: http://www.persee.fr/web/revues/home/prescript/revue/ofce

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Cited by:
  1. Bruno Ventelou & Vincent Touze, 2001. "Politique de santé dans un modèle macroéconomique," Sciences Po publications info:hdl:2441/4303, Sciences Po.

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