Health care budgeting in France

This chapter presents the evolution of the institutions and policies developed in France to ensure the fiscal sustainability of the French health care system. Particularly notable was the introduction of the National Objective for Healthcare Spending (ONDAM) targets in 1996. This was later improved with the introduction of an early warning system, which allows payments to be withheld from health providers, and the official validation of targets by the Parliament. On the revenue side, this chapter examines how the introduction of the Contribution Sociale Généralisée (CSG) has successfully reduced reliance on wage-based contributions for health insurance.