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<p>This article explores the healthcare education reform in France initiated under President Emmanuel Macron, emphasizing the abolition of the <i>numerus clausus</i> and the emergence of new “medical-administrative” elites as key policy insiders. Through a detailed analysis of two central figures, Lionel Collet and Isabelle Richard, we demonstrate how these actors—whose profiles diverge from traditional welfare elites—effectively navigated the decision-making landscape to enact significant reforms. By situating their roles within the Programmatic Action Framework, we highlight the sociological construction of their legitimacy and the evolution of health policy priorities from cost containment to concerns around healthcare provision and workforce management. The study underscores the necessity of considering hybrid medical-administrative profiles to fully understand contemporary healthcare policy dynamics in France.</p>

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Decision-making and policy insiders: the case of France’s healthcare education reform

  • 期刊论文

  • 发表日期：

    2026年6月1日

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  • Matthias Brunn,
  • Masha Kharkhordine,
  • William Genieys,
  • Patrick Hassenteufel

摘要

This article explores the healthcare education reform in France initiated under President Emmanuel Macron, emphasizing the abolition of the numerus clausus and the emergence of new “medical-administrative” elites as key policy insiders. Through a detailed analysis of two central figures, Lionel Collet and Isabelle Richard, we demonstrate how these actors—whose profiles diverge from traditional welfare elites—effectively navigated the decision-making landscape to enact significant reforms. By situating their roles within the Programmatic Action Framework, we highlight the sociological construction of their legitimacy and the evolution of health policy priorities from cost containment to concerns around healthcare provision and workforce management. The study underscores the necessity of considering hybrid medical-administrative profiles to fully understand contemporary healthcare policy dynamics in France.