Paris V., Polton D.
The Ordinance for the simplification of hospital and other medical facilities planning passed in September 2003, aims at:
Merge in a single tool (the regional strategic plan) the strategic planning of hospital facilities and activities which was
before managed through several tools; To decentralize to the regional hospital agency almost all types of authorizations
for hospital activities, facilities and other medical equipments.
Couffinhal A., Grignon M.
A reform of health insurance is devised along two maon lines: On efficiency grounds, how much and on which services
should the patient be held responsible for his medical costs? On efficiency and equity grounds, how should the supply
of voluntary health insurance be regulated and subsidised. Regulations should impose a degree of risk-pooling and
benefits standardization. A report to the Government is due on June 2004.
Couffinhal A., Grignon M.
The reorganization of the relationship between self-employed health professionals and insurance funds has reached
a stand-still. With trying the implement the reform, specialists entered into a conflict with the funds. In September 2003,
a minimal agreement was enforced for them. However, the coming debates about a global reform of the health insurance schedule in 2004-2005 have sapped many actors' interest in the reform.
Naudin F., Sermet C.
The decree of 27 October 1999 reaffirmed the idea to reimburse pharmaceuticals according to their medical service
rendered, with two objectives. At first, the idea is to promote the use of the most effective and innovative treatments.
Secondly, the expected outcome is the reduction of national health expenditure for medicines.
Couffinhal A., Polton D.
Since the mid-'90s, the relationship between public health insurance funds and health professionals has been
deteriorating. Following strikes in 2000, the minister of health sought to renew dialogue with health professionals
and sat up a panel of experts to renovate the contractual relationship between health insurance funds and health
The percentage of nurses' activities that are essentially the administration of personal care has risen rapidly (it represents nearly 70% of the services, the rest being more technical and clinically oriented). As an effort to recentre nurses activity
on the provision of clinical care a nursing care plan “Démarche de soins infirmier” has been introduced.
In June 2003 the government drafted a bill to clarify the missions of the institutions that are responsible for public health
and to define public health objectives for the next five years.
Since 1994, the prices of pharmaceuticals in France have been set by negotiations between the Economic Committee
for Medical Products (CEPS) and the manufacturers. The idea of reform represents a real change to this policy,
whereby pharmaceutical companies can be authorized to set prices for genuinely innovative products, in order
to accelerate their marketing.
The current French government, elected in June 2002, has announced that both public and private hospitals should move
to a prospective payment by activity (i.e. a payment per DRG, complemented by payments for specific activities or missions, which would also be calculated according to the level of production measured through relevant units of account).