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 Medical Insurance: the Impossible Plugging of the Danaids Barrel


Jean de KERVASDOUÉ ** Membre, Académie des technologies ; chroniqueur, Le Point.fr ; professeur émérite, CNAM. Contact : jean@kervasdoue.com.

It took 75 years (1925-1999) to France to create a universal health insurance system. In the beginning, it was exclusively financed thru social taxes based on salary, it was then partially extended to every source of income. These tax bases methods of financing are totally unrelated to the factors which influence medical care demand: demography, medical innovations, epidemies, demand which is almost infinite since medical expenses are free. Given that, for ethical and economic reasons, the market is not working, it was necessary to use rationing methods to reach a financial equilibrium, never reached. Inequitable, inegalitarian, these unsophisticated methods, seldom more complex that the rule of three, blow up from time to time, it is the case to-day. It is however possible to better adjust between supply and demand of medical care while stop playing a repetitive and boring psychodrama plaid by governments for half a century when they try, without success, to limit medical expenditures.