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La fonction de préférence de l'Etat. Le cas de l'assurance maladie en France

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  • Michel Mougeot
  • en coll°. avec Florence Naegelen

Abstract

[eng] Implicit government objective function in french health care system. . In this paper, we consider the regulatory capture assumption in the French health care system. We use a multitask approach to characterize the first best allocation when cost reduction and quality enhancement effort is observable. Then we consider the implicit regulator's objective function implemented by the payment mechanisms used in the French system. We show that the cost reimbursement mechanism and the so-called "envelope" policy place less weight on patients sur­plus than on hospital surplus. These results seem to prove there has been evidence of regulatory capture. [fre] La fonction de préférence de l'Etat. Le cas de l'assurance maladie en France. . Cet article considère l'hypothèse d'une captation de régulation dans le système de santé français en cherchant à mettre en évidence la fonction de préférence implicite de l'État sous-jacente au choix des mécanismes d'allocation retenus. Après avoir rappelé quelques évidences empiriques concernant le système français, l'article présente un modèle de type multitask représentant sa régulation. L'allocation de premier rang est caractérisée. L'article cherche ensuite quelle fonction objectif concrétise les règles de remboursement du coût et d'enveloppe globale utilisées en France. Les analyses empirique et théorique montrent que la politique retenue accorde plus d'importance au surplus des producteurs de soins qu'à celui des patients accréditant l'idée d'une captation de régulation.

Suggested Citation

  • Michel Mougeot & en coll°. avec Florence Naegelen, 1999. "La fonction de préférence de l'Etat. Le cas de l'assurance maladie en France," Revue Économique, Programme National Persée, vol. 50(3), pages 361-382.
  • Handle: RePEc:prs:reveco:reco_0035-2764_1999_num_50_3_410081
    Note: DOI:10.3406/reco.1999.410081
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    Cited by:

    1. B. Dormont & C. Milcent, 2001. "Prospective Payment Systems and Hospital Heterogeneity," THEMA Working Papers 2001-14, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
    2. B. Dormont & C. Milcent, 2000. "Coûts hospitaliers et tarification par pathologie. Le cas de l'infarctus du myocarde aigu," THEMA Working Papers 2000-25, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.

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