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Quelles fonctions économiques pour des opérateurs de soins dans le système de santé français ?

  • Philippe Choné
  • Michel Grignon
  • Ronan Mahieu

[fre] Philippe Choné Michel Grignon Ronan Mahieu Quelles fonctions économiques pour des opérateurs de soins dans le système de santé français ? Cet article part d'un constat empirique : dans de nombreux pays, une nouvelle fonction économique émerge, qui consiste non seulement à acheter des soins de manière avisée, mais aussi à développer et à faire vivre des réseaux de professionnels. La question centrale est alors la suivante : Comment cette fonction peut-elle s'insérer dans un système de santé financé de manière socialisée ? Nous supposons que le niveau des dépenses de santé et le panier de soins minimal sont donnés et nous demandons sous quelles conditions une concurrence entre opérateurs, basée sur la qualité des soins, pourrait constituer un mécanisme de régulation viable et efficace. Nous concentrons notre attention sur l'arbitrage efficacité/sélection et les problèmes de régulation liés à la qualité des soins. [eng] Introducing Managed Care in the French Health Care System. Implementing managed care techniques seems highly desirable to improve productive efficiency on health care markets. We describe an abstract regulatory framework featuring « health operators » competing in a fully state-financed system. The competition process does not concern the insurance side (the state provides health insurance for the whole population), but only the characteristics of the health services (each individual freely chooses his operator on a quality basis). The operators receive a risk-adjusted premium for each customer and contract for services with health care providers. We compare this model with current experiments in Europe and the United States. We analyse the tradeoff between efficiency and selection in this context and evaluate regulatory costs of the model.

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Article provided by Programme National Persée in its journal Revue française d'économie.

Volume (Year): 16 (2001)
Issue (Month): 1 ()
Pages: 169-214

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Handle: RePEc:prs:rfreco:rfeco_0769-0479_2001_num_16_1_1451
Note: DOI:10.3406/rfeco.2001.1451
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