Abstract
In this article, the Director General of the Health Watch Institute (Institut de veille sanitaire) analyses the main issues on which French healthcare policy will depend in the future. He underlines the need to conciliate aims which are becoming more and more contradictory : control of public spending and equitable access to increasingly efficient but costly medical progress. In a critical analysis of the implications of these needs, he describes how recent reforms have tried to achieve such a synthesis. On the issue of “health democracy”, the article underlines the societal dimension of an area of public action, the importance of which increases along with the demands of an ageing population.
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