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Généralisation de la complémentaire santé d’entreprise : une évaluation ex ante des gains et des pertes de bien-être

Author

Listed:
  • Aurélie Pierre

    (IRDES Institut de recherche et documentation en économie de la santé)

  • Florence Jusot

    (Université Paris-Dauphine Leda-Legos, IRDES Institut de recherche et documentation en économie de la santé)

  • Denis Raynaud
  • Carine Franc

    (INSERM Institut national de la santé et de la recherche médicale, IRDES Institut de recherche et documentation en économie de la santé
    IRDES Institut de recherche et documentation en économie de la santé)

Abstract

Depuis le 1er janvier 2016, les employeurs du secteur privé ont l’obligation de proposer et de financer partiellement une complémentaire santé à tous leurs salariés. Elle s’accompagne en sus d’une amélioration de la portabilité de cette complémentaire pour les chômeurs jusqu’à douze mois après la rupture du contrat de travail. Cette réforme a été largement soutenue par les pouvoirs publics qui souhaitent généraliser, à tous, la couverture santé par une complémentaire de qualité. Elle pose toutefois un certain nombre de questions en termes d’équité et d’efficacité. En effet, non seulement elle exclut de facto la quasi totalité des individus sans emploi qui sont plus souvent précaires, mais en plus, elle contraint les salariés à ne pas pouvoir choisir leur niveau de couverture santé optimal au regard de leurs besoins de soins et de leurs préférences. En mobilisant le cadre théorique de l’utilité espérée, nous proposons dans ce travail de simuler les gains et les pertes de bien-être à attendre de cette réforme sur l’ensemble de la population. Nous mobilisons les données de l’Enquête santé et protection sociale (ESPS) de 2012, appariées aux données de remboursements de l’Assurance maladie à partir desquelles nous élaborons une situation contrefactuelle de la réforme de l’Accord national interprofessionnel (Ani). Nous tenons compte en particulier des effets indirects que cette réforme devrait induire sur le marché individuel de la complémentaire santé et sur le marché du travail, et mobilisons un indicateur subjectif des préférences des individus vis-à-vis du risque. Les résultats montrent que, lorsque l’on considère que l’Ani induira une augmentation des primes des contrats individuels et une diminution des salaires, le bien-être collectif devrait se réduire. Le gain en bien-être des salariés qui bénéficient de la réforme est en effet contrebalancé par la perte de bien-être subie par les personnes couvertes par un contrat individuel ou que la réforme oblige à s’assurer. La moitié de la population verrait son bien-être se réduire pour seulement 7 % de gagnants. Ce sont les individus les plus fragiles, c’est-à-dire les plus pauvres et les plus âgés, qui seraient particulièrement concernés par une réduction de leur bien-être.

Suggested Citation

  • Aurélie Pierre & Florence Jusot & Denis Raynaud & Carine Franc, 2018. "Généralisation de la complémentaire santé d’entreprise : une évaluation ex ante des gains et des pertes de bien-être," Working Papers DT75, IRDES institut for research and information in health economics, revised Jun 2018.
  • Handle: RePEc:irh:wpaper:dt75
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    References listed on IDEAS

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    2. Christine Le Clainche & Pascale Lengagne, 2019. "The Effects of Mass Layoffs on Mental Health," Working Papers DT78, IRDES institut for research and information in health economics, revised May 2019.

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    More about this item

    Keywords

    Espérance d’utilité; Aversion au risque; Complémentaire santé;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement

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