De la responsabilité individuelle aux priorités collectives. Une analyse institutionnaliste des politiques de la demande en santé

Abstract

Moral hazard remains the gold standard of and constitutes a theoretical and empirical justification for increasing the financial contributions of patients. The contestation of the notion of moral hazard had lead to a moral turn and advocates a segmentation of patients into those for whom co-payments increase individual responsibility and those for whom co-payments reduce access to care. This paper shows that identification of collective priorities in healthcare conflicts with the moral hazard approach. Priority setting in healthcare is not justified in instrumental terms. Priorities are related to the shared expression of societal values and defended independently of the mainstream conception of responsibility.