Health insurance to reduce inequality in France? It works!

Paris, Monday, February 28, 2022-It is published by the Bureau of Research, Research, Assessment and Statistics (DREES), which makes it possible to measure the impact of health insurance as a tool to reduce some inequality. It is a document that was made.

Health care costs in France account for 8.7% of GDP, and 77.8% of this spending is covered by health insurance. The latter operation, as we know it, is based on a simple system. That is, income-based financing and universal benefits differentiated by care and patient. In a naughty way, the two authors of the study Matthew Fouquet and Catherine Pollack link this principle to the Marxist maxim. From each according to the means to each as needed “.

This principle results in double redistribution. The horizontal one between illness and health, and the vertical one that is not often quoted between the wealthy and the most modest. The Ines-Omar model developed by DREES aimed to study the weight of the public and private factors of the health insurance system on household income in 2017 (after the so-called gradual introduction of 100% health). ..

€ 5,000 per household

Social security covers an average of € 5,000 per year for medical expenses per household and for reimbursement of medical expenses. The numbers are higher on a discreet background. 40% of the poorest households average € 6,000, while 10% of the richest households cost € 4,400. This difference can be explained especially by health. Health is worsening among the poorest on average, with a higher proportion of the elderly among the poorest.

Support that is mechanically transformed into the most modest increase in household purchasing power.

Financing to reduce inequality

At the same time, as a mandatory taxation system, the health insurance system relies on greater contributions from the wealthiest households. All financial (taxes collected, benefits paid) or in-kind (education, health, etc.) that affect primary income (income from work and income from assets) and alternative income (retirement pension, unemployment) Public health insurance contributes 20% to the reduction of inequality, with the contribution of funding them (such as benefits by taking into account the public transfer of).

This redistribution effect is basically based on the profit added to the disposable income. These represent almost 40% of the most modest 20% disposable income. But as the authors of the study point out: However, it should be noted that the redistribution effect measured here is partially related to the poor health of the low-income group. “.

In wealthy households, the rest paid after repayment is significantly higher than in low-income households. These differences are partially offset by higher repayments from complementary health insurance, but the final out-of-pocket costs that directly weigh on the household increase with living standards.

The premiums paid by households for complementary health insurance policies rise sharply with the standard of living. This, among other things, reflects the existence of income-differentiated pricing, as well as higher guarantees and higher repayments from complementary health insurance.

Disconnected disposable income of the elderly

Finally, the interesting thing about the survey is that the household’s direct medical costs (out-of-pocket costs after mandatory and complementary insurance interventions, and complementary health insurance premiums) are proportional to the budget of low-income households. Income that weighs more heavily. Available. In addition, the weight of medical costs within the budget increases sharply with age, rising from 2.7% between the ages of 30 and 39 to 8.2% after the age of 80.

CH