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A quoi tient la solidarité de l’assurance maladie entre les hauts revenus et les plus modestes en France ?


  • Florence Jusot
  • Renaud Legal
  • Alexis Louvel
  • Catherine Pollak
  • Amir Shmueli


This article analyses the solidarity of the French health insurance system with a new index which measures the cross-subsidies from the rich to the poor induced by health expenses and financing, using the 2012 In?s-Omar microsimulation model. The solidarity index is decomposed by financing sources (public and private insurances and out-of-pocket payments) and discussed with respect to equity principles. The solidarity is less driven by the horizontal equity in use of the system than by the vertical equity in finance insured by the progressivity of the public part of the system. The magnitude of social health inequalities explains a large part of the concentration among the poorest of public health expenses, even if the solidarity of the system is limited by barriers to access to care.

Suggested Citation

  • Florence Jusot & Renaud Legal & Alexis Louvel & Catherine Pollak & Amir Shmueli, 2016. "A quoi tient la solidarité de l’assurance maladie entre les hauts revenus et les plus modestes en France ?," Revue française d'économie, Presses de Sciences-Po, vol. 0(4), pages 15-62.
  • Handle: RePEc:cai:rferfe:rfe_164_0015

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