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Le recours à l’Aide complémentaire santé : les enseignements d’une expérimentation sociale à Lille

Author

Listed:
  • Sophie Guthmuller

    (LEDA-LEGOS - Laboratoire d’Economie et de Gestion des Organisations de Santé - LEDa - Laboratoire d'Economie de Dauphine - IRD - Institut de Recherche pour le Développement - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres - CNRS - Centre National de la Recherche Scientifique)

  • Florence Jusot

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

  • Jérôme Wittwer

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

  • Caroline Després

    (IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres)

Abstract

Le dispositif de l'Aide complémentaire santé (ACS) a été mis en place au 1er janvier 2005 afin d'inciter les ménages dont le niveau de vie se situe juste au dessus du plafond CMU-C à acquérir une couverture complémentaire santé (CS). Même si le nombre de bénéficiaires a lentement progressé depuis son introduction, le recours à l'ACS reste faible. Deux hypothèses peuvent être formulées pour expliquer cet état de fait : (1) Le défaut d'information sur l'existence du dispositif, son fonctionnement et sur les démarches à entreprendre pour en bénéficier. (2) Le montant de l'aide est insuffisant, une CS resterait trop chère même après déduction de l'aide. Cet article cherche à tester la validité de ces deux hypothèses dans le cadre d'une expérimentation contrôlée au niveau d'une Caisse primaire d'assurance maladie (CPAM) (à Lille). Trois groupes d'assurés ont été aléatoirement constitués ; le premier groupe (groupe témoin) s'est vu proposer le montant d'ACS en vigueur, le deuxième groupe (groupe traité 1) a reçu une proposition d'aide majorée et le troisième groupe (groupe traité 2) a reçu en plus d'une proposition d'aide majorée, une invitation à une réunion d'information sur le dispositif. L'analyse des taux de dossiers de demande retournés par groupe ainsi que le nombre d'ACS accordées rend compte des conclusions suivantes :(1) La majoration du « chèque santé » a un effet faible mais significatif sur le recours à l'ACS. (2) De manière inattendue, l'invitation à la réunion d'information annule l'effet de la majoration du chèque. (3) Assister à la réunion augmente cependant de manière significative la probabilité de retourner un dossier de demande. Cette étude confirme ainsi que l'ACS est un dispositif compliqué qui touche difficilement sa cible. Par ailleurs, les bénéficiaires d'une CS ne répondent pas de manière significativement différente des personnes qui n'en bénéficient pas, ce qui laisse à penser que la question centrale du non-recours à l'ACS n'est pas celle du coût de la CS mais plus certainement celle de l'accès à l'information et celle du coût et de la difficulté des démarches, l'incertitude pesant sur l'éligibilité étant un facteur aggravant.

Suggested Citation

  • Sophie Guthmuller & Florence Jusot & Jérôme Wittwer & Caroline Després, 2011. "Le recours à l’Aide complémentaire santé : les enseignements d’une expérimentation sociale à Lille," Post-Print hal-04117464, HAL.
    • Handle: RePEc:hal:journl:hal-04117464
    Note: View the original document on HAL open archive server: https://hal.science/hal-04117464
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    References listed on IDEAS

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    Cited by:

    1. Florence Jusot & Clémence Perraudin & Jérôme Wittwer, 2011. "L’accessibilité financière à la complémentaire santé en France : les résultats de l’enquête Budget de Famille 2006," Économie et Statistique, Programme National Persée, vol. 450(1), pages 29-46.
    2. Thomas Barnay & Carine Franc & Florence Jusot, 2015. "Introduction : La santé et les soins : prise en charge, déterminants sociaux, conséquences professionnelles," Économie et Statistique, Programme National Persée, vol. 475(1), pages 17-29.
    3. Thomas Barnay & Carine Franc & Florence Jusot, 2015. "Introduction générale. La santé et les soins : prise en charge, déterminants sociaux, conséquences professionnelles," Post-Print hal-02431053, HAL.
    4. Mohamed Ali Ben Halima & Thierry Debrand & Camille Regaert, 2012. "Sick Leaves: Understanding Disparities Between French Departments," Working Papers DT50, IRDES institut for research and information in health economics, revised Oct 2012.

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    More about this item

    Keywords

    Subvention; Assurance Santé; France; Ménages pauvres; Expérimentation sociale; DT LEDa-LEGOS;
    All these keywords.

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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