A number of measures have been introduced in recent years to deal with the chronic deficit within the health branch of the Social Security Department, including, in 2008, exemptions in respect of certain reimbursements or medical procedures. This particular measure, which meant that certain medical expenses of insured persons were no longer to be reimbursed in full, proved controversial on grounds of unfairness. That controversy could be ended by the establishment of a national "health shield", as suggested by the High Commissioner for Active Solidarities against Poverty, Martin Hirsch.
François Ecalle lays out in this article what this "health shield" might consist in (a system in which there would be a ceiling on health expenses for the insured as a function of their incomes), it being largely inspired by the systems of Belgium and Germany. He also presents the aims of such a "shield": fairer access to care, a way of balancing the sickness insurance accounts, and a simplification of the insured's financial contribution to the scheme. Possible consequences include relatively limited redistributive effects, an undoubtedly major impact on additional insurance schemes, and a return to the basic principles of Social Security, according to which all pay according to their abilities and receive according to their needs, with no loss of efficiency in the health system. In short, François Ecalle sees it as an opportunity to be seized. And, if a rapid political decision is forthcoming, it could be in place as early as 2010.