Lhe aborted pension reform highlighted the importance of debating upstream of any systemic change affecting our social model. As the National Council of Resistance (CNR) did in 1943 with regard to Social Security, a broad citizen consensus on the imperative and urgent overhaul of our health system is essential.
This is the ambition of the Health Institute, an apolitical and independent citizens’ initiative created in 2018, which aims to rethink the health system as democratically as possible in order to face the crises of the 21st century.e century. Here are some principles that emerged from this collective reflection.
Rather than a health model centered on the supply of care, the new model should be focused on the health needs of the population and individuals. To enable this, the geographic steering unit will become the health area, bringing together 120,000 to 150,000 people and including a few living areas. It will then be necessary for the territory to replace all the other health perimeters which have multiplied in recent years – hospital groups of territories, territorial professional health communities, public assistance-Paris hospitals, etc. -, thus leading to administrative simplification. he will then become the scope of activity of all health professionals, whose missions include territorial health responsibility.
This development induces and justifies an overhaul of the Debré ordinances of 1958 – which notably created university hospital centers and centered the organization of health around the hospital. The objective of this “Debré 2” will be to open the walls of the hospital, to put an end to the systematic full-time hospital and to accelerate the extension of teaching and research outside the hospital. He will then be able to decompartmentalize health, which will no longer be organized solely according to the city, the hospital and the medico-social, but according to the territory and the health needs of the people who live there.
Health and social democracy
This approach can be done while respecting the free choice of employee, liberal or mixed statuses of professionals – statutes which will, if necessary, be legally adapted to this territorial reality. Whatever the status considered, this new territorial horizon must be accompanied by greater diversification of professional careers for all caregivers. A powerful lever for regaining attractiveness in all healthcare professions.
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