Public health insurance policies in France

Extending coverage or controlling expenditure

Bibliographic Data

ID19224972
AuthorsRaphaëlle Sors (Université Paris Dauphine-PSL, corresponding author)
Year2026
Publication date2026-05-28
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrench Politics (JOURNAL)
Journal identifiersISSN: 1476-3427 • E-ISSN: 1476-3419
PublisherPalgrave Macmillan (PUBLISHER • GB)
DOI10.1057/s41253-026-00324-8
OpenAlexW7162631353
LanguageEN
References cited19

This paper explores the tension at the heart of French Social Security between the expansion of healthcare coverage and the control of health insurance expenditure. The paradox of the French system lies in its effort to reconcile two seemingly irreconcilable imperatives: guaranteeing universal access to care while maintaining budgetary balance. Although successive reforms are justified in the name of urgency, efficiency, and morality, they have progressively redefined universality. Instead of disappearing, it has become fragmented and conditional, while existing as an ideal invoked to legitimize financial discipline. In practice, these reforms have shifted part of the financial burden from collective solidarity to households and complementary insurers, reinforcing inequalities of access. The article argues that this redefinition of universality results from a long-term process of reframing cost containment as an act of preservation rather than retrenchment

Cognitive reframing · Health care · Health care reform · Health insurance · Inequality · Public health · Social security · Solidarity · Healthcare Systems and Practices · Healthcare Systems and Reforms · Social Policies and Family

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