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Europeanized, Marketized but Still Governed by the State? Private Health Insurance in France

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Abstract

Historically, private health insurance (PHI) in France (which covers the complementary share of health expenditures) has been dominated by non-profit entities, namely mutual benefit societies. The sector has experienced a manifold marketization process over the recent years, partly due to the application of EU law and regulation. Yet this chapter argues that it has been decisively reinforced and sometimes shaped by a series of policies adopted at the national level. Indeed, over the last 20 years, successive French governments have tried to increase health coverage without increasing the share already covered by the public purse. This strategy ostensibly involved private health insurers in achieving several governmental objectives, yet the prior effects of Europeanization on these entities were poorly acknowledged by policymakers. As such, the many consequences associated with the rise of a “European-driven” market now increasingly conflict with a “State-driven” market. This, in turn, has strong implications for the scope and the nature of health coverage.

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Fig. 7.1

Notes

  1. 1.

    The Assurance maladie (literally, “Sickness Insurance”), more commonly known as Sécurité sociale (literally, “Social Security”).

  2. 2.

    The governing board became anadvisory board in 2004.

  3. 3.

    This figure includes groups and independent companies and excludes companies within groups.

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Coron, G., Houssoy, T., Benoît, C. (2021). Europeanized, Marketized but Still Governed by the State? Private Health Insurance in France. In: Benoît, C., Del Sol, M., Martin, P. (eds) Private Health Insurance and the European Union. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-54355-6_7

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