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Social Security – The ineffectiveness and the pernicious effects of health cost containment policies in France

par Valentin Petkantchin
vendredi 9 mars 2007.


Paris, 9 March 2007 - While the issue of the future of the health system is conspicuous by its absence during the presidential campaign and that a showdown is pitting unions of general practitioners against public health insurance over tariffs, time has come to rethink seriously health cost containment policies in France, according to a new study released by the Institut économique Molinari.

“We must yield to evidence. Whereas letting public health spending go is not tenable, the various rationalization plans of Social Security in the 1980’s and 1990’s, as well as the more recent cost containment measures, have just failed,” declares Valentin Petkantchin, author of the study.

Indeed, after 1988, the general health insurance scheme has regularly been in the red, with deficits attaining sometimes close to 12 billion euros, as in 2004.

The picture is particularly bleaker since 1996 even if reforms have imposed the cost containment of public health expenditures, including the national target for health insurance spending (ONDAM). Deficits accumulated from 1997 to 2006 thus attain more than 49 billion euros (abiding by inflation), that is to say, an amount twice higher compared to deficits of the previous decade.

A bureaucratic drift

“Much more serious, however, is the ever-growing number of regulations which lead to a creeping bureaucratization of the overall health system,” according to Mr. Petkantchin.

On the one hand, with regard to patients. For example, even if it is not yet an obligation, the new “coordinated care pathway” scheme encroaches upon the insured persons’ freedom to select and seek medical care from the physician/specialist of their choice.

On the other hand, with regard to healthcare providers. Leaving aside the regulation of their tariffs over which public authorities exert control since long, the manifold reforms seek more and more to control the practice of health professionals. The freedom of exercise of private office-based physicians as well as the conditions of practice in hospitals, are here again more and more regulated.

“If public authorities uphold this trend towards cost containment, French patients will have to prepare themselves to face the rationing of healthcare and waiting lists in the future, much like those that characterize, for example, the British and the Canadian health systems” concludes the author.

Entitled, The ineffectiveness of health cost containment policies in France, the study is available at :…

Information and interview requests :
Valentin Petkantchin, PhD
Director of Research
Institut économique Molinari
Rue du Luxembourg 23, Boîte 1
1000 Bruxelles, Belgique
Tél : +33 4 42 53 46 19 GSM : +33 6 50 82 40 93

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