[The National Health Agency: the challenge of a unified national program rejecting technocratic and centralized...

The creation of Regional Health Agencies precipitated the need for an overhaul of national health policy management. The National Steering Committee created as part of the HPST law is only a step in the right direction. We need to go beyond the coordination of national policy-makers in order to develop and implement an effective health policy. The creation of a National Health Agency (ANS) is generally considered to be the best way to develop a national steering mechanism capable of developing and implementing a global health policy. The purpose of this new body is not to act as a "super health agency" encompassing all existing health agencies. Rather, the ANS should aim to be an instrument of regulation acting on health care organization and funding and the quality and effectiveness of health care practices. In this sense, its role is to bring together state services and National health insurance services. However, there are two different conceptions of the agency's role ? as an autonomous technical entity based on the current model of the CNAMTS or as a body under the authority of the Ministry of Health. In both cases, the ANS may serve to increase the emphasis on technocratic and centralized approaches to health management. An intermediate solution between the ANS and the current status quo would involve increasing the authority of the Secretary-General of the Social Ministries over the central bodies of the Ministry of Health, the National health insurance services and the National Solidarity Fund for Autonomy. As part of this mission, the Secretary-General would oversee a specific body with national jurisdiction. While integrating a more coherent national policy as well as maintaining the decision-making bodies of the current administrative system, this intermediate solution would help to avoid a radical restructuring of existing national institutions at a time when current challenges in the area of population health require immediate attention.