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Systèmes mixtes d'assurance maladie, équité, gestion du risque et maîtrise des coûts

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  • Stéphane Jacobzone

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[fre] Systèmes mixtes d'assurance maladie, équité, gestion du risque et maîtrise des coûts . par Stéphane Jacobzone . Cet article étudie le caractère mixte des systèmes d'assurance maladie, en recensant notamment les divers arguments plaidant en faveur de l'intervention publique. Ceci concerne les principes redistributifs et les dysfonctionnement potentiels des mécanismes d'assurance. On montre l'intérêt de modèles de choix collectifs pour comprendre la nature des équilibres réalisés. Ceci permettra d'aborder les difficultés liées à la gestion des incitations dans les systèmes d'assurance maladie. Parmi les facteurs contribuant à l'évolution de la dépense, le rôle des interactions entre assureurs/payeurs et offreurs de soins semble déterminant, en particulier le rythme et le type d'innovation technologique privilégiée par les remboursements. Une réflexion sur les modes d'organisation montre l'intérêt de formes intégrées pour la prise en charge, éventuellement couplées avec un développement de paiements forfaitaires pour les offreurs. [eng] Mixed Health-Insurance Systems, Equity, Risk Management and Cost Control . by Stéphane Jacobzone . This paper studies the mixed nature of health-insurance systems, listing the various arguments in favour of state intervention. The latter include the redistribution principle and potential dysfunctions in insurance systems. The importance of collective-choice models for understanding the nature of balances is demonstrated. This makes it possible to address problems relating to incentive management in health-insurance systems. Of the factors which affect expenditure patterns, the interaction between insurers/payers and care providers would seem to be determining, especially as regards the pace and type of technological innovation encouraged by reimbursement. A discussion of organisational forms shows the advantage of integrated methods of social security coverage, possibly coupled with development of lump-sum payments for the providers.

Suggested Citation

  • Stéphane Jacobzone, 1997. "Systèmes mixtes d'assurance maladie, équité, gestion du risque et maîtrise des coûts," Économie et Prévision, Programme National Persée, vol. 129(3), pages 189-205.
    • Handle: RePEc:prs:ecoprv:ecop_0249-4744_1997_num_129_3_5873
    DOI: 10.3406/ecop.1997.5873
    Note: DOI:10.3406/ecop.1997.5873
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