Skip to main content
SpringerLink
Log in

Welfare Elites as Custodians of State Policies

  • Chapter
  • First Online:
Elites, Policies and State Reconfiguration

Part of the book series: International Series on Public Policy ((ISPP))

  • 28 Accesses

Abstract

Our elite approach highlighted, with a series of portraits, the change in the social background and career paths of the first generation of welfare elites that adopted the role of custodians of state policies in the social security sector. Most of them came from the Cour des comptes. They developed their career paths by circulating at the top of power (the Directorate of Social Security, the National Health Insurance Fund, and ministerial cabinets). They were strongly connected to each other reinforced the community spirit around the new programmatic orientation and the reform of the governance of social security. They had a common vision of the need to move toward a system of universal coverage increasingly financed by taxes and controlled by Parliament.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  2. 2.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  3. 3.

    The Inspection Générale des Affaires Sociales (IGAS) is an inspection corps dedicated to social affairs. https://www.igas.gouv.fr/spip.php?article737

  4. 4.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  5. 5.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  6. 6.

    Ibid.

  7. 7.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  8. 8.

    Ibid.

  9. 9.

    Ibid.

  10. 10.

    Ibid.

  11. 11.

    Ibid.

  12. 12.

    Ibid.

  13. 13.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  14. 14.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  15. 15.

    Ibid.

  16. 16.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  17. 17.

    Ibid.

  18. 18.

    Ibid.

  19. 19.

    Ibid.

  20. 20.

    Interview with social insurance high civil servant (MiRe 2, 2007).

  21. 21.

    Ibid.

  22. 22.

    Ibid.

  23. 23.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  24. 24.

    Interview with social insurance high civil servant (MiRe 2, 2007).

  25. 25.

    Ibid.

  26. 26.

    Interview with social insurance high civil servant (MiRe 1, 1998).

  27. 27.

    Interview with social insurance high civil servant (MiRe 2, 2007).

  28. 28.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  29. 29.

    Ibid.

  30. 30.

    Ibid.

  31. 31.

    Ibid.

  32. 32.

    Ibid.

  33. 33.

    Ibid.

  34. 34.

    Ibid.

  35. 35.

    Soubie, Raymond (ed.), Santé 2010. Rapport du groupe « Prospective du système de santé ». Paris, La Documentation Française, 1993. https://bdsp-ehesp.inist.fr/vibad/index.php?action=getRecordDetail&idt=76591

  36. 36.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  37. 37.

    The Contribution Sociale Généralisée, called CSG, is a new tax created in 1990 to finance the social insurance system. The CSG is levied on all types of personal incomes and it funds approximately 30% of expenditure on health care (Hassenteufel and Palier 2007: 590).

  38. 38.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  39. 39.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  40. 40.

    Ibid.

  41. 41.

    Ibid.

  42. 42.

    Ibid.

  43. 43.

    Interview with social insurance high civil servant (MiRe 1, 1998).

  44. 44.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  45. 45.

    Bulletin de l’Ordre des Médecins, janvier 1999: 16.

  46. 46.

    A “médecin référant” (referring physician) is a general practitioner who has signed a contract with the health insurance fund. Generally speaking, he undertakes to contribute to the control of health care costs, in particular by respecting several criteria such as the application of conventional tariffs, the procedure for waiving the advance payment of expenses or the respect of a specific quality charter.

  47. 47.

    Interview with social insurance high civil servant (MiRe 1, 1997 & MiRe 2, 2007).

  48. 48.

    Ibid.

  49. 49.

    Ibid.

  50. 50.

    Ibid.

  51. 51.

    Interview with social insurance high civil servant (MiRe 1, 1998 et MiRe 2, 2006).

  52. 52.

    https://www.alternatives-economiques.fr/assurance-maladie-chi-va-piano-va-sano/00020749

  53. 53.

    Interview with social insurance high civil servant (MiRe 1, 1998 et MiRe 2, 2006).

  54. 54.

    Interview with social insurance high civil servant (MiRe 2, 2007).

  55. 55.

    Created in 1988, the RMI is intended to guarantee a minimum level of resources and facilitate the integration or reintegration of people with low incomes. The RMI is paid to anyone who meets the following conditions: residing in France, at least 25 years old (except in special cases: pregnant women, etc.), having resources below the amount of the RMI and signing an integration contract.

  56. 56.

    The Carte vitale is the health insurance card first issued in 1998.

  57. 57.

    The COG is a policy instrument based on a target and management agreement between doctors’ organizations and health insurance funds (Hassenteufel 2007: 585).

  58. 58.

    The health shield is a system for capping all out-of-pocket expenses, that is the costs that remain payable by consumers of medical goods and services after the intervention of the social security system.

  59. 59.

    Interview with social insurance high civil servant (MiRe 1, 1997).

  60. 60.

    Interview with social insurance high civil servant (MiRe 2, 2006).

  61. 61.

    Ibid.

Bibliography

  • Barbet, André, Raoul Briet, « Financement et régulation du système de protection sociale », Revue française d’économie, 3(1), 1988: 51–80.

    Article  Google Scholar 

  • Fonteneau, Robert, A la mémoire de Jean Marmot. Fascicule complémentaires, Paris, Comité d’histoire de la Sécruité sociale, 2008.

    Google Scholar 

  • Fragonard, Bertrand, Vive la protection sociale!, Paris, Odile Jacob, 2012.

    Google Scholar 

  • Frémaux, Philippe, « Assurance Maladie: chi va piano va sano », Alternatives Économiques, n°173, le 01/09/1999.

    Google Scholar 

  • Genieys, William, The New Custodians of the State. The Programmatic Elites in French Society, New Brunswick, NJ, Transactions Books, 2010.

    Google Scholar 

  • Grimaldi, André, Didier Tabuteau, François Bourdillon, Frédéric Pierru, Olivier Lyon-Caen, Manifeste pour une santé égalitaire et solidaire, Paris, Odile Jacob, 2011.

    Google Scholar 

  • Hassenteufel, Patrick, « L’État mis a nu par les politiques publiques », in B. Badie, Y. Déloye, (dir), Le temps de l’État. Mélanges en l’Honneur de Pierre Birnbaum, Paris, Fayard, 2007: 311–329.

    Google Scholar 

  • Hassenteufel, Patrick, Bruno Palier, “Trompe-l’œil in the Governance of Health Insurance. French-German Contrasts”, Revue française d’administration publique, 113, 2005: 13–27.

    Article  Google Scholar 

  • Hassenteufel, Patrick, Bruno Palier, “Toward a Neo-Bismarkian Health Care States? Comparing Health Insurance Reforms in Bismarkian Welfare States”, Social Policy & Administration, 41 (6), 2007: 574–596.

    Article  Google Scholar 

  • Jobert, Bruno, (ed.), Le tournant néo-libéral en Europe, Paris, L’Harmattan, 1994.

    Google Scholar 

  • Johanet, Gilles, Santé: dépenser sans compter, des pensées sans conter, Paris, Santé de France, 1995.

    Google Scholar 

  • Johanet, Gilles, Sécurité sociale: l’échec et le défi, Paris, Seuil, 1998.

    Google Scholar 

  • Libault, Dominique, Julien Damon, (entretien) « Grand témoin: Gilles Johanet, procureur général près de la cours des comptes », Regards, 2017: 11–26.

    Google Scholar 

  • Rodwin, Victor, Claude Le Pen, “Health Care Reform in France. The Birth of State-Led Managed Care”, New England Journal of Medicine, 351 (22), 2004: 2259–62.

    Article  Google Scholar 

  • Suleiman, Ezra N., « Sur les limites de la mentalité Bureaucratique: conflits de rôles entre cabinets ministériels et directeurs », Sociologie du travail, 14 (4) 1972: 388–409.

    Article  Google Scholar 

  • Suleiman, Ezra N., Politics, Power and Bureaucracy in France: The Administrative Elite, Princeton (NJ), Princeton University Press, 1974.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre for European Studies and Comparative Politics, Sciences Po, Paris, France

    William Genieys

  2. CEPEL (UMR 5112), University of Montpellier, Montpellier, France

    Mohammad-Saïd Darviche

Authors
  1. William Genieys
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammad-Saïd Darviche
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William Genieys .

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Genieys, W., Darviche, MS. (2023). Welfare Elites as Custodians of State Policies. In: Elites, Policies and State Reconfiguration. International Series on Public Policy . Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-031-41582-1_5

Download citation

Publish with us

Policies and ethics

Search

Navigation