Public health systems in the age of financialization: lessons from the French case

Abstract

Public Health Systems (PHS) are under continuous transformation in line with economic, political, and ideological changes in capitalist economies. The current stage of capitalism is underpinned by the process of financialization, meaning an increasing dominance of financial actors, markets, practices, measurements, and narratives over other agents, including the State. This article examines how financialization has been reshaping PHS, with an in-depth study of the French case. First, we suggest how to incorporate the concept of financialization into the research on PHS transformation. We then apply this concept to reassess the trajectory of the French system from the 1990s onwards. We show the increasing participation of financial capital for long-term, short-term, and infrastructure financing, occupying roles previously fulfilled by the public sector. We then discuss how the adoption of financialized strategies led to shifts in how public actors behave, and the potentially adverse effects for solidarity, stability, and democratic participation.