Book excerpt: This book examines the history of the French welfare state from the mid-twentieth century to the present day. The French social security system has changed profoundly over the last few decades. The Bismarkian model of governance and social protection inherited from the Second World War has progressively faded away in favor of a reinforcement of the state’s capacity to intervene on policies and the implementation of national health insurance coverage. In order to understand this major transformation, this book draws on rich original sources to offer a historical and sociological perspective on elite policymakers and policy change. In doing so, it identifies correlations between the changing social backgrounds and career paths of elites in charge of social insurance policies since the 1940s, and the development of health policy programs. It will appeal to all those interested in public policy, health policy, social studies and French history and politics.