Incitations financières et concurrence dans les systèmes de santé

[eng] Since the beginning of the 80s, national health systems have, in all countries, been subjected to quite radical changes. In most major OECD countries — except for the US and France — , the growth of health expenditures has been moderated; the modes of compensation for doctors and hospitals have been modified; competition and more appropriate pecuniary incentives have been introduced. In Eastern Europe, the issue is still debated: what kind of system should be put in place? In the USSR, experiments similar to what has been done in the US and the UK are being conducted. So far, France has mostly remained untouched by these reforms. [fre] Les systèmes de santé sont partout l'objet de profonds bouleversements depuis 1980. Les grands pays de l'OCDE ont maîtrisé leurs dépenses de santé (sauf les Etats-Unis et la France), modifié la rémunération des médecins ou hôpitaux et introduit la concurrence et des incitations financières. A l'Est, on s'interroge : quels nouveaux systèmes de santé adopter ? L'URSS conduit des expériences proches de celles menées aux Etats-Unis et au Royaume- Uni. La France reste largement à l'écart de ces grandes réflexions.