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https://doi.org/10.12759/hsr.46.2021.1.35-58

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

Erosion der Solidarität in Frankreich und Wohlfahrtskonventionen: Die neue Rolle der Zusatzkrankenversicherung
[Zeitschriftenartikel]

Batifoulier, Philippe
Domin, Jean-Paul
Rauly, Amandine

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 correspond... mehr

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.... weniger

Thesaurusschlagwörter
Gesundheitswesen; Solidarität; Gesundheitspolitik; Krankenversicherung; Frankreich; Zusatzversicherung; Ungleichheit

Klassifikation
Gesundheitspolitik

Freie Schlagwörter
Economics of convention; health system; concept of solidarity; complementary health insurance; welfare conventions

Sprache Dokument
Englisch

Publikationsjahr
2021

Seitenangabe
S. 35-58

Zeitschriftentitel
Historical Social Research, 46 (2021) 1

Heftthema
Conventions, Health and Society - Convention Theory as an Institutionalist Approach to the Political Economy of Health

ISSN
0172-6404

Status
Veröffentlichungsversion; begutachtet (peer reviewed)

Lizenz
Creative Commons - Namensnennung 4.0


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