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Related Experiment Videos

Rationing health care in France.

P J Lancry1, S Sandier

  • 1Caisse Nationale d'Assurance-Maladie des Travailleurs Salariés (CNAMTS), 66 avenue du Maine, 75694, Paris, France. pj.lancry2cnamts.fr

Health Policy (Amsterdam, Netherlands)
|May 29, 2000
PubMed
Summary

French healthcare reforms since 1995 aimed to control costs and improve quality through measures like user charges and provider limits. These systematic changes require time and physician support for successful implementation.

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Area of Science:

  • Health Policy
  • Healthcare Management
  • Public Health

Background:

  • French healthcare system underwent significant legislative changes since the 1995 Plan Juppé.
  • Reforms focused on financing, service provision, priority setting, and rationing.
  • Over two decades, systematic changes impacted healthcare demand, supply, and pricing.

Purpose of the Study:

  • To analyze the main features of French healthcare financing and provision.
  • To examine priority setting and rationing issues within the French system.
  • To evaluate the impact of legislative measures on healthcare services.

Main Methods:

  • Analysis of legislative measures and policy changes since 1995.
  • Examination of demand-side controls (user charges) and supply-side controls (professional limits, hospital beds).
Keywords:
Health Care and Public Health

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  • Review of payment systems (administrative prices, global budgets) and new features (expenditure targets, gatekeeper system, practice guidelines, accreditation).

    • Main Results:

    • Demand control strategies included increased user charges in ambulatory and hospital care.
    • Supply control measures involved limiting health professionals and hospital beds.
    • New features in 1996 targeted cost-containment and quality, including parliamentary involvement in expenditure targets and a gatekeeper system (médecin référent).

    Conclusions:

    • Healthcare reforms in France are complex and face implementation challenges.
    • Acceptance and success of reforms depend on time and physician support.
    • Ongoing systematic changes reflect a continuous effort to manage the French healthcare system.