Public policies aimed at maintaining people’s health and autonomy constitute two major pillars of social protection. Public spending on health represents around €200 billion per year (or 8.6% of GDP in 2018), far ahead of spending on disability and invalidity (€38bn in 2014) or loss of autonomy for the elderly (€11.4bn in 2014, excluding health).

The IPP’s “health and autonomy” program focuses on these public policies in their entirety. The aging of the French population, the creation of a fifth branch of social security dedicated to autonomy, and the health crisis that began in 2020 make them particularly topical.

However, public policies on autonomy are now both numerous and fragmented, with income maintenance benefits, compensation benefits, home help, care in medical and social institutions, tax reductions and credits. Some of these are implemented at the national level, others at the regional or departmental level, which raises the question of equity across the country. Finally, an important part of the support for autonomy is provided by family caregivers.

IPP Focus. In this context, the main themes of the program are:

• The redistribution operated by the public coverage of health, disability and dependency risks.
• The different benefits dedicated to disability and dependency: their effects on the trajectory of beneficiaries, their redistributive effects, territorial disparities in their implementation, potential reforms of these benefits.
• The adequacy of the supply to the needs in the territory, particularly in terms of medico-social establishments and home help services.
• The projection of future care needs, using the “dependency” module of the TaxIPP-Life dynamic microsimulation model.
• The articulation between private and public care, and the effect of the help provided by informal caregivers on their own health.