Abstract
The French Health Insurance system has experienced major changes in the 1990’.. The 1996 reform is rather paradoxical because it is a mix of liberalisation (through the introduction of competition mechanisms) and strengthening of the State. This mix of State improvement (mainly illustrated by the limitation of health insurance expenses by fixed budgets) and liberalisation (illustrated by the promotion of competition mechanisms) is not a French peculiarity: it is more the sign of a convergence trend for all European health care systems. This is why there is a blurring of the differences with the British health care system. Financial constraints, changes in policy networks (which were partly the side-effects of previous cost containment policies) and political mobilisation explain these reforms in the French case
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