The generalization of third-party payment: economic stakes and consequences for the actors of the health system.

Summary The generalization of third-party payment was adopted by the National Assembly in April 2015 as part of the new Health Law. By 2017, it will allow all patients to avoid having to pay in advance to the doctor and then wait for reimbursements from the AMO (Compulsory Health Insurance) and the Ocam (Supplementary Health Insurance Organizations), if necessary. The questioning of this French specificity is fuelling lively debates between the different actors of the health system: doctors, patients and insurers (AMO and Ocam). Several questions, more or less well-founded, run through these debates and will structure our discussion: -Is the generalization of third-party payment fair? -Does it make care free? -Is the generalization of third-party payment inflationary? -Is it the "programmed death" of liberal medicine? -Does it give full powers to the compulsory health insurance? Moreover, in the background, at a time when the injunction of prevention is omnipresent in the law on the modernization of our health system, more pressing questions for the health system are posed with acuity: its efficiency, equity of access to primary care, the development of information systems, the coordination of health care actors and even the social acceptability of the current system.