Patient empowerment in public healthcare funding system reform: A power network perspective

Aziza Laguecir*, Christopher S. Chapman, Florian Gebreiter, Celia Lemaire

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review


This paper examines a reform of the French healthcare system, aiming to empower patients and improve their access to care. Conceptually, we draw upon Emerson's Power Dependence Theory to trace how various adverse consequences for patients arose in practice. Specifically, already socio-economically disadvantaged groups of patients found their positions becoming even more precarious. Rather than empowering patients, the reform resulted in private health insurance providers emerging as critical actors and primary beneficiaries of power network changes. The healthcare system-level analysis highlights the significance of patients as a direct focus of healthcare system reform and the importance of considering their position within the power network, which is crucial to understanding reform outcomes. This attention to the power network adds to the potential for the extant theorisation of the effects of reform of funding mechanisms on the nature of patient empowerment and access to healthcare.
Original languageEnglish
JournalAccounting Forum
Publication statusAccepted/In press - 12 Apr 2024


  • Healthcare reform
  • Power network
  • Patient Empowerment
  • Physicians excess fees
  • Tariffs
  • Healthcare Fragmentation


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