Individual reimbursements to “guarantee sufficient coverage for the entire population at an acceptable price”. It is in a spirit of greater social equity that the reform of theHealth Insurance advocated by two economists Pierre-Yves Geoffard and Grégoire de Lagasnerie.
In the system of deductibles and ceilings devised by experts and explained in the journal Économie et Statistique, from INSEE, each socially insured person would benefit from reimbursement of his care in proportion to his income taken individually (and not in based on household income).
Only city care is mentioned by economists, which still represents 53% of the consumption of medical care and goods, or 96 billion euros in health insurance expenditure in 2011.
The reform proposes the establishment of an annual deductible imposed on all policyholders and at an equal or modulated level according to income. Thanks to this common base, people with more modest or even precarious incomes could benefit from larger refunds than insured persons with mutual insurance, for example.
The authors assure that this new system would allow “a real improvement in the management of patients with significant expenses”.
If this principle of franchises already exists in other European countries such as Sweden or the Netherlands, it is highly likely that it will spark a long debate before it is seriously considered in France. Because that would be tantamount to making a choice between the current system based on principled equality of access to care and a perhaps more equitable system considered on a case-by-case basis.
