Proposal for a Reform-Based Budgeting of the Financing of the French Statutory Health Insurance System

Rémi PELLET * Professeur, Université de Paris et Sciences Po Paris. Contact : https://remipellet.wordpress.com.Cet article reprend des éléments de travaux personnels publiés dans des revues juridiques et qui sont synthétisés dans Pellet (2021b).

In this article, we recommend that the French public authorities include revenues and expenditures from the statutory health insurance system in the State Finance Act (instead of separately in the Social Welfare Scheme (Sécurité sociale) Financing Acts as is the case today), as this would provide the possibility for a number of essential reforms: simplifying the financial circuits of the Social Welfare Scheme; extending the latter's tax base; abolishing the current distinction between social welfare debt and other public debt. These measures would not entail a dismantling of the Social Welfare Scheme Financing Acts. They should furthermore be coupled with giving greater powers and discretion to the French National Union of Health Insurance Funds (UNCAM) tasked with financing the cost of all care (both for public hospitals and private health practitioners).