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How Financialization Reshapes Public Health Care Systems - The Case of Assurance Maladie


  • Ana Carolina Cordilha

    () (Centre d'Economie de l'Université de Paris Nord (CEPN))


This article seeks to show how financialization is reshaping Public Health Care Systems (PHCS). To do so, we combine a theoretical discussion and an empirical investigation to examine the increasing participation of financial actors and instruments in these systems over the last decades. In the first part, we present the conventional approach for assessing PHCS transformation to date and argue for the need to incorporate the concept of 'financialization'. In the second part, we suggest a method for empirically examining how financialization alters the internal structures and organization of PHCS. In the last part, we apply this method to conduct an in-depth analysis of the French public health system, Assurance Maladie (AM). Our findings provide robust evidence that financialization had a major influence in the direction taken by the post-1990s reforms in this case, with new strategies allowing the increased participation of financial capital in the system's long-term, short-term, and investment financing. In the conclusion, we provide a critical assessment of financialized strategies, highlighting their adverse impacts on core principles of PHCS such as solidarity, stability, and democratic participation.

Suggested Citation

  • Ana Carolina Cordilha, 2020. "How Financialization Reshapes Public Health Care Systems - The Case of Assurance Maladie," CEPN Working Papers 2020-03, Centre d'Economie de l'Université de Paris Nord.
  • Handle: RePEc:upn:wpaper:2020-03

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    References listed on IDEAS

    1. Ève Chiapello, 2017. "La financiarisation des politiques publiques," Mondes en développement, De Boeck Université, vol. 0(2), pages 23-40.
    2. Philippe Batifoulier & Nicolas da Silva & Jean-Paul Domin, 2018. "Économie de la santé," Post-Print hal-02020032, HAL.
    3. Christine André & Philippe Batifoulier & Mariana Jansen-Ferreira, 2016. "Privatisation de la santé en Europe. Un outil de classification des réformes," CEPN Working Papers hal-01256505, HAL.
    4. Eve Chiapello, 2017. "La financiarisation des politiques publiques," Post-Print hal-02538415, HAL.
    5. Kate Bayliss & Elisa Van Waeyenberge, 2018. "Unpacking the Public Private Partnership Revival," Journal of Development Studies, Taylor & Francis Journals, vol. 54(4), pages 577-593, April.
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    More about this item


    Health; Health Care Financing; Public Health; National Government Health Expenditure; Social Security; Deficit; Debt; General Financial Markets;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
    • H62 - Public Economics - - National Budget, Deficit, and Debt - - - Deficit; Surplus
    • H63 - Public Economics - - National Budget, Deficit, and Debt - - - Debt; Debt Management; Sovereign Debt
    • G1 - Financial Economics - - General Financial Markets

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