Steering from bismarck to beveridge: the french experience

• Main Author: Philippe Mossé (Author)
• Format: Book
• Published: Universidade de Fortaleza, 2018-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.5020/18061230.2018.8781; 1806-1230
• Keywords: Health; Care; Administrative Personnel; Medicine (General); R5-920; Public aspects of medicine; RA1-1270
• Source: Revista Brasileira em Promoção da Saúde, Vol 31, Iss 4, Pp 1-7 (2018)

Objective: To describe the roots of the French Health Care System. Data synthesis: Actually, three dynamics are hidden behind the word crisis. The first dynamic was already there from the start, while the second is the result of an internal dynamic and a third dynamic can be seen as the consequence of external causes. The main recent policies are made of a mix of constraints and incentives. Most of them improve the governance of the health care system. Adaptive as well as innovative, a pragmatic attitude has been applied through compromises. Four features of which can be found: To improve the division of labor amid professionals; to move towards Beveridge like Welfare State model, giving to the central State more power; to enhance expertise through Evidence Based Medicine; to open the internal and external frontiers of the health care system. Conclusion: Those changes were mainly pulled by the moving context rather than pushed by an ideology. Therefore, since its birth, the French health care system evolves more on a muddling through like move than according to a plan given in advance. This happened to be a rather good way to avoid the worst: marketization.