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The search for the Holy Grail: combining decentralised planning and contracting mechanisms in the French health care system

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  • Martine M. Bellanger
  • Philippe R. Mossé

Abstract

France has recently adopted one of the least market‐oriented models for reforming its health care system, where competition does not feature at all prominently in the overall policy design.This country has a strong tradition of top‐down public administration, and health professionals, trade unions and the general public are all uneasy about the idea of introducing market forces and privatising public health provision. The main reforms discussed in this article were based on planning, rationalisation, cost‐containment, efficiency and equity. However, some embryonic changes and emerging practices can be detected which might seem to relate to the ‘new public management’ approach, and which could also serve as a basis for future market initiatives. Copyright © 2005 John Wiley & Sons, Ltd.

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  • Martine M. Bellanger & Philippe R. Mossé, 2005. "The search for the Holy Grail: combining decentralised planning and contracting mechanisms in the French health care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 119-132, September.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s119-s132
    DOI: 10.1002/hec.1031
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    References listed on IDEAS

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    1. Yutaka Imai & Stephane Jacobzone & Patrick Lenain, 2000. "The Changing Health System in France," OECD Economics Department Working Papers 269, OECD Publishing.
    2. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687, July.
    3. Tangeras, Thomas P., 2002. "Collusion-proof yardstick competition," Journal of Public Economics, Elsevier, vol. 83(2), pages 231-254, February.
    4. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    5. Andrei Shleifer, 1985. "A Theory of Yardstick Competition," RAND Journal of Economics, The RAND Corporation, vol. 16(3), pages 319-327, Autumn.
    6. Wagstaff, Adam & van Doorslaer, Eddy, 1992. "Equity in the finance of health care: Some international comparisons," Journal of Health Economics, Elsevier, vol. 11(4), pages 361-387, December.
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    Cited by:

    1. Kristian Bolin & Anna Lindgren & Björn Lindgren & Petter Lundborg, 2009. "Utilisation of physician services in the 50+ population: the relative importance of individual versus institutional factors in 10 European countries," International Journal of Health Economics and Management, Springer, vol. 9(1), pages 83-112, March.
    2. Martin Chalkley, 2018. "Private Provision of Publicly Funded Health Care: The Economics of Ownership," Briefing 002055, Office of Health Economics.
    3. Helene Barroy & Zeynep Or & Ankit Kumar & David Bernstein, 2014. "Sustaining Universal Health Coverage in France: A Perpetual Challenge," Health, Nutrition and Population (HNP) Discussion Paper Series 91323, The World Bank.

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