Health Care Reform in France

The World Health Organization recently ranked the French health care system the best in the world. Although the methods and data on which this assessment was based have been criticized, there are good grounds for being impressed by the French system. Yet in August 2004, with the national health insurance (NHI) system facing a severe financial crisis, France enacted Minister of Health Philippe Douste-Blazy’s reform plan. Like previous efforts at
health care reform, this one seeks to preserve a system of comprehensive benefits, which is supported by the major stakeholders. French policymakers typically view their NHI
system as a realistic compromise between Britain’s National Health Service, which they believe requires too much rationing and offers insufficient choice, and the mosaic of subsystems in the United States, which they consider socially irresponsible because 15 percent of the population younger than 65 years of age has no health insurance. Whether reform modernize
the health care sector and increase the quality of care, and it promises to control costs by increasing the efficiency of resource allocation within targeted expenditure limits. In these respects, the reform will reinforce the powerful role of the central state,
which will oversee vast institutional renovation, apply administrative and information technology to health care, and design incentives and regulations to improve quality. The limitations of state-led managed care, however, are rooted in the centralization
of policymaking in France and the successful resistance of the medical profession to all efforts at micromanaging medical practice and second-guessing physicians’ authority.


Mariam Ahmad