What impact do preventive health programs have on the "self-prevention-insurance" trade-off of policyholders?

Summary Comparative competition between European health systems does not support the French case. For the same or even lower health expenditures, several European partners show better results in terms of disability-free life expectancy at age 65 and in terms of the rate of premature deaths avoidable by primary prevention before age 65. Faced with this paradox, the institutional reforms implemented in recent years have aimed to shift the focus from curative to preventive medicine. In a context of public deficit, the incentives aim to favour the development of a prevention market linked to the complementary health insurance market. With the National Interprofessional Agreement (ANI) put in place since 2016, private sector companies are obliged to offer supplementary health insurance to their employees. By this agreement, collective insurance contracts, but by contamination also individual contracts, are accompanied by an offer, often included and free of charge, of prevention programs ensuring a personalized accompaniment of the insured in their lifestyle and health. This article examines the consequences from the point of view of the insured of adhering to such prevention programs. In particular, we analyze the impact of this free prevention offer on the trade-off between prevention effort and insurance coverage. We show that the management of moral hazard risk is strongly affected in this context compared to the predictions of insurance models in line with the seminal article by Ehrlich and Becker (1972). Our results highlight under-insurance in primary prevention and over-insurance in secondary prevention.