[The political economy of health policy in the socialist government: the record after five years of power in France, l981-1986].
One cannot say that health was put to the forefront of the reform projects of the left-wing parties and, in particular, of the Socialist Party before their coming to power in May 1981. One cannot say, either, that after the departure of the Socialists in April 1986, the reforms that they accomplished in this area have been considerable. However, some of them are not negligible, even if one cannot yet measure all their effects completely. The policy drive has been marked by two periods. The first was characterized by a profusion of projects and by strong political promises, i.e. from June 1981 to March 1983. It was the period when the Minister of Health was a Communist and when the Social Security administration was linked to another ministry. It was the period of reforms which were promised but not realised, e.g. those concerned with health and labour, those that touched on the issue of psychiatric hospitals. It was the period, nevertheless, when some of the reforms could have been undertaken with success: the reforms of medical education, of the establishment of the Regional Observatories of Health, of the decentralisation of some sectors of the health system, of the elimination of private sector beds in public hospitals. The second, from April 1983 to July 1985, was characterised by an attempt to modify the modality of the functions of the health system. It was during this period that the office of the Minister of Health was reduced to that of Secretary of State attached to the Minister of Social Affairs, whose main concern was with research regarding balancing budgets and who, relatively speaking, succeeded in his rigorous attempt to curb medical costs. One can point out, however, that an attempt was made to bring about 'the integrated health centre', an attempt corresponding to the wish of the militant socialists but which was to have no effect except as a symbolic gesture. But the main reform, launched by the law of 19 January, 1983, was that which was concerned with the mode of financing hospitals by replacing daily hospital fees with general financial budgets, the amounts of which were to be negotiated between the hospitals and the administrative boards. This reform would expand into broader activities, i.e. the creation of the entire organisation of hospitals to a great extent. This reform attempted to introduce the advantage of collective discussion of problems among the persons responsible, no longer nominated by the central authority but elected by their peers.(ABSTRACT TRUNCATED AT 400 WORDS)
Aiach
P
P
INSERM, Unité 164, Villejuif, France.
Delanoe
J Y
JY
D004469:Economics, Hospital / Q000331:legislation & jurisprudence; D005380:Financing, Government / Q000639:trends; D005602:France; D005102:Health Expenditures / Q000331:legislation & jurisprudence; D006291:Health Policy / Q000191:economics / Q000639:trends*; D012950:Socialism
La politique economique du gouvernement socialiste en matiere de sante: bilan de cinq annees de pouvoir en France, 1981-1986.