the subject of the regionalisation of the health system is important. Tantot brandi as REMEDE miracle, tantot denonce as utopia. For 20 years, regionalisation has been progressing, gently, by small, successive keys. Paradoxically, any drastic overhaul has a hypothetic regional health agency. Today the observer loses. Too many structures, missions, funding, etc. The regionalisation of the health system is not for the future. Except for policies to make a choice between three scenarios that are telescoping: full decentralisation in favour of the regions, concentration that made the State more open to each administrative region, or a return to an insurable approach, which would give the health insurance funds a total delegation.