Le « trou de la Sécu », trou noir du débat public sur la réforme du système de santé français

The problem of the “Trou de la Sécu” (“blind spot”) is monopolizing the public debate on the French healthcare reform since the creation of Social Security. As the financial situation of the institution deteriorated, it increased its influence, particularly since the early 90s. Such ubiquity, which serves diverse interests, precludes more relevant and productive questions about the future of the French healthcare system: Is the growth of healthcare expenditures an asset or a burden to the “competitiveness” of the French economy? What should be the level of public spending? How can we better use the money dedicated to health? Finally, the “Trou de la Sécu” is a commonplace undermining confidence, when it is used in rhetorical dramatization, in the sustainability of public health insurance and justifies the transfer of an increasing proportion of health expenditure to private health insurance market.