Quel avenir pour le système de Santé ?

The French health system is facing a double challenge: epidemic of chronic diseases, and financial sustainability of the social security established in 1945. Our system is very good for caring acute illness, but is inadequate for the management of chronic diseases. And this, on four areas: prevention, medical model, organization, and ways of funding. The second challenge is the increase health spending reaching 11.6% of GDP in 2013. Beyond the cost of new drugs, there is a problem of dual ways of refunding for each care: social security, and private health insurance. This duality is responsible for a very high cost of health management, up to 16 billion euros. The inevitable increase in health care spending, due to aging and medical progress, within a restricted budget, will lead to choose between two solutions: increase in privatization of routine care funding, social security refocusing on the poorest people and on the patients with the more severe and costly diseases, or separate the care supported by the community and the care relating to personal choice supported by private insurance. An intermediate solution would be to allow those who wish, to choose the social security as additional insurance, for an additional fee.