AFSP Conferences

Congrès de l’Association de Science Politique Française

In Collaboration with the American Political Science Association (APSA)

Past AFSP FPG Panels and Roundtables

Splendeurs et misères du système de santé français : un modèle paradoxal ?

The French Health Care Paradox: The Best or Worst of Times?

Organized by :

Elisa Chelle (Université Paris Nanterre) elisa.chelle@parisnanterre.fr Isabel M. Perera (Cornell University) isabel.m.perera@cornell.edu

The Covid-19 epidemic has renewed attention to the politics of health (Bergeron et al., 2018), laying bare the importance of range of issues: from how elites make public policy decisions to whether the public consents to them. France’s “whatever it costs” policy has increased health care funding massively, breaking with decades of budget cuts. The reforms undertaken during the Macron’s first term (“Ma Santé 2022”) aimed to tackle medical deserts (by improving health care supply across the territory, reforming medical education accordingly, and investing in related infrastructure). At the same time, health care workers (nurses, interns, GPs) have never been so mobilized and militant. Their protests, though recurrent in recent history, have become especially prevalent. With rising burnout levels motivating calls to improve working conditions in hospitals, the pandemic crisis has opened up a window of opportunity for medical staff seeking to change public policy. In their telling, the French health care system is in crisis, even on the brink of collapse. Yet international analysts view this same health system as a model, noting in particular its generous insurance coverage and low out-of-pocket expenses (Or et al., 2023). The World Health Organization (2000) described the French health care system as the best in the world. To be sure, France’s public health policy is less developed than the country’s health care system. For example, cancer screening and prevention systems have long struggled – a factor that contributes to cancer’s place as the leading cause of death in France (and not cardiovascular disease, as in the rest of Europe) (Or et al., 2023, p. xxv). On the other hand, other major indicators are quite positive. For example, the OECD estimates that, on average, French people live two years longer than people in other developed countries, partly as a result of the lower prevalence of obesity (and despite their above-average alcohol and tobacco consumption, Organisation for Economic Co-operation and Development, 2021).

This thematic section welcomes papers that interrogate the paradoxes of the French health care system, including and beyond the pandemic. They should examine at least one feature of French health care policy, possibly from a comparative perspective. Examples include: the role of the State, the public hospital, decentralization, the role of social movements, public-private arrangements, the role of the European Union, the organization of care, financing models, or insurance coverage. Moreover, these questions can apply to a variety of health care sub-areas, such as general medicine, vaccine policy, mental health, clinical research, expertise, public health, etc. This thematic section will lead to the publication of a special issue of French Politics in 2025 (papers due autumn 2024, 8’000-10’000 words). Papers may be presented in French or English, but the final papers must be written in English. Submissions in English are strongly encouraged.

Les propositions de communication devront être envoyées par courriel à chacun.e des responsables scientifiques de la ST avant le 8 décembre 2023.

Références / References

• BERGERON, Henri and Patrick CASTEL. Sociologie politique de la santé. 2nd ed. Paris: PUF. 2018.
• OR, Zeynep, Coralie GANDRE, Anna-Veera SEPPÄNEN, et al. France: Health System Review 2023. Report 25(3). The European Observatory on Health Systems and Policies. 2023.
• ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT. Health at a Glance 2021: OECD Indicators. Highlights for France. [s.n.]. 2021.
• WORLD HEALTH ORGANIZATION. “World Health Organization Assesses the World’s Health Systems.” February 7, 2000.