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A quoi tient la solidarité de l’assurance maladie entre les hauts revenus et les plus modestes en France ?

Author

Listed:
  • Florence Jusot

    (LEDa - Laboratoire d'Economie de Dauphine - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres, Legos - Laboratoire d'Economie et de Gestion des Organisations de Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

  • Renaud Legal

    (DREES - Ministère de la santé et de la protection sociale - Ministère de l'emploi, du travail et de la cohésion sociale)

  • Alexis Louvel

    (Institut national de la statistique et des études économiques (INSEE), DREES - Ministère de la santé et de la protection sociale - Ministère de l'emploi, du travail et de la cohésion sociale)

  • Catherine Pollak

    (DREES - Ministère de la santé et de la protection sociale - Ministère de l'emploi, du travail et de la cohésion sociale, LEDa - Laboratoire d'Economie de Dauphine - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

  • Amir Shmueli

    (School of Public Health - University of Michigan [Ann Arbor] - University of Michigan System, Department of Statistics, The Hebrew University - HUJ - The Hebrew University of Jerusalem)

Abstract

This article analyses the solidarity of the French health insurance system with a new index which measures the cross-subsidies from the rich to the poor induced by health expenses and financing, using the 2012 Inès-Omar microsimulation model. The solidarity index is decomposed by financing sources (public and private insurances and out-of-pocket payments) and discussed with respect to equity principles. The solidarity is less driven by the horizontal equity in use of the system than by the vertical equity in finance insured by the progressivity of the public part of the system. The magnitude of social health inequalities explains a large part of the concentration among the poorest of public health expenses, even if the solidarity of the system is limited by barriers to access to care.

Suggested Citation

  • Florence Jusot & Renaud Legal & Alexis Louvel & Catherine Pollak & Amir Shmueli, 2016. "A quoi tient la solidarité de l’assurance maladie entre les hauts revenus et les plus modestes en France ?," Post-Print hal-02430068, HAL.
    • Handle: RePEc:hal:journl:hal-02430068
    DOI: 10.3917/rfe.164.0015
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    Cited by:

    1. Piketty, Thomas & Bozio, Antoine & Garbinti, Bertrand & Goupille-Lebret, Jonathan & Guillot, Malka, 2020. "Predistribution vs. Redistribution: Evidence from France and the U.S," CEPR Discussion Papers 15415, C.E.P.R. Discussion Papers.

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    Keywords

    Assurance-maladie; accès aux soins;

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