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Assurance maladie : Financement collectif et régulation par le marché ?

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  • Michel Grignon

Abstract

[eng] Health insurance system : collective funding and market regulation ? . This article argues in favour of collective, compulsory healthcare funding, with reference to the basic principles of the system (efficiency and fairness) and by addressing the three trends currently aimed at curtailing it (re-definition of the benefit basket, managed competition) if not throwing it entirely into question (medical savings accounts). The author then develops the idea that some form of market could use these collective resources. He tries to show how and why this could improve healthcare management. This is an ideal, but he is unsure whether the cost of the exercise would exceed the gains of moving from our current situation to the optimal one. Finally, privatising healthcare would be a way of avoiding the fundamental questions : how do patients relate to healthcare professionals ? How do they see their profession ? . JEL classification : H51, I11, I18 [fre] Cet article justifie l'idée d'un financement collectif et obligatoire des dépenses de soins, en rappelant les deux arguments sur lesquels elle est fondée (efficacité et équité), puis en tentant de répondre aux 3 tendances visant aujourd'hui à en limiter le champ (définition du panier d'une part, concurrence gérée de l'autre), voire à la remettre totalement en cause (compte d'épargne médical). L'auteur développe ensuite l'idée qu'une forme de marché pourrait utiliser ces ressources collectives. Il tente de montrer comment et pourquoi cela pourrait améliorer la régulation. Il y a là une sorte d'optimum, mais il n'est pas certain que les transactions nécessaires pour y accéder n'excède pas en coûts les gains retirés du passage de notre situation actuelle à la situation optimale. Finalement, cet appel au marché serait une manière d'éviter les questions fondamentales : quelles relations entretiennent les patients avec les producteurs de soins ? Comment voient-ils leur métier ? . Classification JEL : H51, I11, I18

Suggested Citation

  • Michel Grignon, 2004. "Assurance maladie : Financement collectif et régulation par le marché ?," Revue d'Économie Financière, Programme National Persée, vol. 76(3), pages 55-67.
    • Handle: RePEc:prs:recofi:ecofi_0987-3368_2004_num_76_3_4915
    DOI: 10.3406/ecofi.2004.4915
    Note: DOI:10.3406/ecofi.2004.4915
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    References listed on IDEAS

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    1. Matthew Eichner & Mark B. McClellan & David A. Wise, 1998. "Insurance or Self-Insurance? Variation, Persistence, and Individual Health Accounts," NBER Chapters, in: Inquiries in the Economics of Aging, pages 19-49, National Bureau of Economic Research, Inc.
    2. Philippe Choné & Michel Grignon & Ronan Mahieu, 2001. "Quelles fonctions économiques pour des opérateurs de soins dans le système de santé français ?," Revue Française d'Économie, Programme National Persée, vol. 16(1), pages 169-214.
    3. Hurley, Jeremiah, 2000. "An overview of the normative economics of the health sector," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 2, pages 55-118, Elsevier.
    4. Victor R. Fuchs, 2018. "Economics, Values, and Health Care Reform," World Scientific Book Chapters, in: Health Economics and Policy Selected Writings by Victor Fuchs, chapter 39, pages 497-531, World Scientific Publishing Co. Pte. Ltd..
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    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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