Erosion of Solidarity in France and Welfare Conventions: The New Role of Complementary Health Insurance

Philippe Batifoulier, Jean-Paul Domin () and Amandine Rauly ()
Additional contact information
Jean-Paul Domin: REGARDS - Recherches en Économie Gestion AgroRessources Durabilité Santé- EA 6292 - URCA - Université de Reims Champagne-Ardenne - MSH-URCA - Maison des Sciences Humaines de Champagne-Ardenne - URCA - Université de Reims Champagne-Ardenne
Amandine Rauly: REGARDS - Recherches en Économie Gestion AgroRessources Durabilité Santé- EA 6292 - URCA - Université de Reims Champagne-Ardenne - MSH-URCA - Maison des Sciences Humaines de Champagne-Ardenne - URCA - Université de Reims Champagne-Ardenne

Post-Print from HAL

Abstract: The French health system has been structurally in crisis since the early 1980s. This crisis is reflected in the loss of legitimacy of the conventional Fordist vision of national solidarity, which is characterized by a "crisis of legitimacy." The Fordist convention has the particularity of corresponding to a harmonious representation of social justice between the different orders (economic, political, and domestic) of social protection. Contemporary criticism of the health care system uses what was once the basis of institutionalized compromise between orders. The result is a new role for supplementary health insurance. This new role overturns the concept of solidarity that characterizes health policies. A new conventional vision is emerging: the liberal convention. This analysis focuses on the French case where complementary insurance has historically fulfilled solidarity missions. The new status of supplementary protection is accompanied by an unequal drift, which cannot be seen as the expression of a natural antagonism between economic efficiency and social justice. In France, expenditure has remained high while inequalities have increased. These limits have led the legislator to modify its policy by exempting certain patients from contributing to the financing of their own health expenditure. These sensitive adjustments are costly when the initial objective is to reduce expenditure and tend to generate new inequalities.

Keywords: health insurance; supplementary insurance; health care delivery system; France; health policy; inequality; solidarity (search for similar items in EconPapers)
Date: 2021-03-16
Note: View the original document on HAL open archive server: https://hal.science/hal-03171474v1
References: View references in EconPapers View complete reference list from CitEc
Citations:

Published in Historical Social Research / Historische Sozialforschung, 2021, 46 (1), pp.35-58. ⟨10.12759/hsr.46.2021.1.35-58⟩

Downloads: (external link)
https://hal.science/hal-03171474v1/document (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03171474

DOI: 10.12759/hsr.46.2021.1.35-58

Access Statistics for this paper

More papers in Post-Print from HAL
Bibliographic data for series maintained by CCSD ().