Type
Article
Title
Private Health Insurance in France: Between Europeanization and Collectivization
In
The Milbank quarterly
Author(s)
BENOÎT Cyril - Centre d'études européennes et de politique comparée (Author)
CORON Gaël - École des Hautes Études en Santé Publique (EHESP) (Author)
Editor
US : Cambridge University Press
Pages
undefined - Online p.
ISSN
0887378X
DOI
10.1111/1468-0009.12420
Keywords
France, health policy, health insurance, Europeanization, regulation
Abstract
EN
Policy Points: Private health insurance (PHI) in France has been facing critical changes over the past 30 years. A complementary and voluntary scheme, it has been historically dominated by nonprofit entities. However, the share of for-profit insurance companies in the sector has significantly increased. Nonprofit firms also changed their strategies and mimicked some for-profit behaviors. The present paper argues that this process is a result of the conflict-provoking coevolution of the insurance and health care sectors. Trying to improve the regulation of the insurance industry as whole, two European directives first jeopardized the business model of nonprofit entities. Then, two national reforms designed to improve health coverage significantly increased competition among insurers, notably in the area of corporate-level contracts. Decoupling the insurance and health care sectors has become a major source of policy feedback and unexpected outcomes of reforms affecting the very organization of PHI.

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