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The Agency, the Contract, the Incentive. Regional Health Agencies Administrative Health Policy Spearhead

L’agence, le contrat, l’incitation. Les Agences régionales de santé fer-de-lance administratif de la politique de santé

Victor Duchesne

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Abstract: This text shows that the establishment of Regional Health Agencies is a new form of state control of the health system. This new state control marks the transition from the logic of the plan to that of incentive by going beyond the historical oppositions that have animated the health sector (the State against the Social Security, the local regulation against the central regulation and the hospital against the liberal medicine). The incentive for the organization of the health system is based on an original organizational structure (the agency) and a coordination tool (the contract) their unprecedented by its success, its scale and its specificities. However, the couple ARS-contract does not escape the paradoxes of an administration under New Public Management: reform under budgetary constraint and contractually negotiate under supervision. The RHAs themselves are subject to the incentive scheme that they implement.

Keywords: Regional Health Agencies; Health system; Social Welfare; Contractualisation; Administration; Agences Régionales de Santé; Système de santé; Protection sociale (search for similar items in EconPapers)
Date: 2018
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Published in Journal de Gestion et d’Économie Médicales, Editions ESKA, 2018, 36 (4), pp.159-180. ⟨10.3917/jgem.184.0159⟩

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DOI: 10.3917/jgem.184.0159

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