Democracy and Social and Solidarity Economy (SSE) - The example of mutual health insurance in France

Democratic governance is a constitutive element of a large part of social economy enterprises. In France, the first mutuals, in the modern sense of the term, appeared in the early 19th century. Bringing together free and equal citizens sharing a collective identity and wishing to break away from charitable practices based on unequal conditions, mutuals immediately adopted democratic principles. The statutes provide for the compulsory participation of members in the general assembly during which important decisions concerning the management of the mutual are taken. The specific features of democratic practice within mutuals will evolve over time. In the first legally recognised mutuals, the President was appointed by the public authorities to prevent mutual benefit societies from being used as a front for trade union and political activities in a context where trade unions and political parties were prohibited. Democratic practice was then limited to management decisions. With the development of political freedoms, this control was to diminish and eventually disappear, but another form of limitation of democracy was to appear with the supervision of the guarantees offered by the mutual societies. At the same time, the increase in the size of mutuals and in the number of their members limits the possibilities of direct participation of members in management decisions. Democratic practice is evolving towards a representative democracy in which democratic procedures are essentially used to appoint leaders. The democratic exercise is then situated at another level within the governance bodies. These developments, combined with an increase in the consumerist practices of members, mean that mutuals, like other organisations, are suffering from a "democratic crisis" which they are trying to resolve by recreating spaces for exchange and meeting with their members.