Catrice-Lorey, Antoinette

L'assurance maladie et le système de santé - Paris : IIAP, juil./sept. 1987

The author shows how health care austerity policy and the social security crisis have given rise to an added mission for national health insurance (NHI) bodies which, since 1980, have had to evaluate the functioning of the health care system and contribute to improving its efficiency in addition to their current tasks. She describes the history of NHI duties and recent developments in various health care sectors. Including private practise and hospital care, public and private. The missions of all bodies are given. The new powers vested in Social Security are part of long-term government policy; government instruments of self-regulation are analyzed; the specific role of SOcial Security is described in detail, i.e. how it maintains ongoing dialogue towards negotiated change with health care professionals, over an above authoritarian regulations and economic restrictions. In fact, the State relies on NHI to adjust societal regulations so as to try to buld a consensus for its policy. The proper execution of this new function assumes a re-destribution of roles among individuals and bodies active in NHI. This would modify the configuration of an already complex power structure. The article also describes the problems arising within NHI from the growing importance of consulting physicians