A quoi peut servir la concurrence en assurance santé ?

Cet article analyse quelles modalités de concurrence dans l'assurance santé peuvent améliorer l'efficience du système tout en satisfaisant a certains impératifs d'équité. L'analyse s'appuie sur des arguments théoriques et quelques expériences étrangères. La régulation des relations entre les professionnels de santé et les patients est mise au centre de notre approche. En particulier, les stratégies d'organismes d'assurance en concurrence -actions sur les producteurs de soins, différentiation des contrats de couverture, sélection des risques - sont évaluées en fonction de la latitude qui leur est laissée. Nous espérons ainsi éclairer le bien fondé des récentes réformes entreprises en France. [Auteurs] This paper studies how competition in health insurance markets may improve the health system efficiency, while respecting some equity constraints. The analysis is based upon theoretical arguments, and lessons drawn from some recent reforms in other countries. The regulation of the relationship between health care professionals and patients is central to our approach. In particular, the strategies of insurance firms in a competitive market--actions on health care producers, differentiation of insurance contracts, risk selection--depend on how the system is regulated. We hope that this analysis helps to assess some recent reforms undertaken in France. [Authors]]]> Insurance, Health ; Economic Competition fre oai:serval.unil.ch:BIB_E81CB33F863F 2023-07-29T01:37:04Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_E81CB33F863F Data protection and ethics requirements for multisite research with health data: a comparative examination of legislative governance frameworks and the role of data protection technologies. info:doi:10.1093/jlb/lsaa010 info:eu-repo/semantics/altIdentifier/doi/10.1093/jlb/lsaa010 info:eu-repo/semantics/altIdentifier/pmid/32733683 Scheibner, J. Ienca, M. Kechagia, S. Troncoso-Pastoriza, J.R. Raisaro, J.L. Hubaux, J.P. Fellay, J. Vayena, E. info:eu-repo/semantics/article article 2020 Journal of law and the biosciences, vol. 7, no. 1, pp. lsaa010 info:eu-repo/semantics/altIdentifier/pissn/2053-9711 urn:issn:2053-9711 <![CDATA[Personalised medicine can improve both public and individual health by providing targeted preventative and therapeutic healthcare. However, patient health data must be shared between institutions and across jurisdictions for the benefits of personalised medicine to be realised. Whilst data protection, privacy, and research ethics laws protect patient confidentiality and safety they also may impede multisite research, particularly across jurisdictions. Accordingly, we compare the concept of data accessibility in data protection and research ethics laws across seven jurisdictions. These jurisdictions include Switzerland, Italy, Spain, the United Kingdom (which have implemented the General Data Protection Regulation), the United States, Canada, and Australia. Our paper identifies the requirements for consent, the standards for anonymisation or pseudonymisation, and adequacy of protection between jurisdictions as barriers for sharing. We also identify differences between the European Union and other jurisdictions as a significant barrier for data accessibility in cross jurisdictional multisite research. Our paper concludes by considering solutions to overcome these legislative differences. These solutions include data transfer agreements and organisational collaborations designed to `front load' the process of ethics approval, so that subsequent research protocols are standardised. We also allude to technical solutions, such as distributed computing, secure multiparty computation and homomorphic encryption