The search for the Holy Grail: combining decentralised planning and contracting mechanisms in the French health care system.
France has recently adopted one of the least market-oriented models for reforming its health care system, where competition does not feature at all prominently in the overall policy design. This country has a strong tradition of top-down public administration, and health professionals, trade unions and the general public are all uneasy about the idea of introducing market forces and privatising public health provision. The main reforms discussed in this article were based on planning, rationalisation, cost-containment, efficiency and equity. However, some embryonic changes and emerging practices can be detected which might seem to relate to the 'new public management' approach, and which could also serve as a basis for future market initiatives.
Bellanger
Martine M
MM
Ecole Nationale de la Santé Publique, Avenue du Pr Léon Bernard, 35 043 Rennes, France. martine.bellanger@ensp.fr
Mossé
Philippe R
PR
D003363:Cost Control; D005376:Financial Management / Q000458:organization & administration*; D005602:France; D015276:Health Care Rationing / Q000458:organization & administration; D018166:Health Care Reform / Q000191:economics / Q000458:organization & administration*; D006297:Health Services Accessibility; D006801:Humans; D009042:Motivation; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D011057:Politics; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012051:Reimbursement Mechanisms / Q000458:organization & administration; D014850:Waiting Lists