[The risks of good health in France in the year 2020]

Abstract

Since 1995 onwards, health cost containment is the order of the day in France. Successively, the Right and the Left were implementing strong policies aimed at curbing hospital costs, controlling drug prescriptions, promoting early retirement of practicing doctors.... As expected, all these actions have encountered hard resistances from health professionals (As a matter of fact, the demand side was not affected by cost containment policies). The inertia of all the system and the resistance from health personnel made it clear that cost containment measures will obtain a significant impact only after 2003 or 2005. Precisely, at that date, or some years later, the medical profession will start a sharp decrease of its numbers as the graduate-boom cohorts of the period 1975-1990 will arrive at retirement age. On the demand side, the French population will accelerate its aging process as the baby-boomers born during the period 1945-1965 will reach successively their 60th anniversary. In other words, the decade 2010-2020 will see a sharp growth of the demand for health services and a decrease in the supply. As cost containment is a painful and long-harvesting process, the health authorities of the decade 2010-2020 will probably not let "the horse run freely again". Most probably, supply of health care will be kept under strict control. Will France then adopt the British model (health expenditures kept at low level and queuing for care)? Or will the nation be innovative enough to invent a new model for its health system?