7th Business & Management Conference, Budapest

THE FRENCH HEALTH CARE SYSTEM AT A JUNCTURE: STAKEHOLDER ANALYSIS, NETWORKS AND IDIOSYNCRATIC REFORMS

DANIEL SIMONET

Abstract:

The French health system was at a juncture in the 2000s. Policy makers faced multiple conflicting expectations from a variety of stakeholders. Our aim is to investigate two critical stakeholders: patients, whose sovereignty was weakened, and physicians, whose values have shifted. The provision of health services took a different shape. The emphasis is now on territorial networks.Our approach consists of a literature review that investigated the critical elements of French health care reforms. As such, the article will trace the evolution of health care stakeholders, , the impact of reforms on patient sovereignty and on physician’s professional values. In retrospect, it appears that the invasion of norms led to a democratic recess that reinstated the French Jacobinist tradition at the expense of citizen engagement and patient sovereignty. As for physicians who remained the last gatekeeper of ethics, they developed new coping and anchoring strategies.The article gives a critical appraisal of the prevailing administrative principles contained in the French administrative apparatus, and how these were translated into practice with respect to the uniformisation of services and the concentration of power within a newly-formed Welfare elite.France adopted an idiosyncratic market model that contrast with Anglo-Saxon Public Private Partnerships and consumer-driven approach. Verticalization of the chain of command and concentration of decision-making power became salient characteristics of French reforms that contrast with Anglo-Saxon de-amalgamation strategies.

Keywords: Health Care, Participation, Citizen Engagement, New Public Management, France

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