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Talking about a healthcare “system” to describe an historically fragmented and compartmentalized French health sector, in which state bureaucracies and sickness insurance funds struggled to regulate professional and political strategies, has long been a misnomer. As a counterpoint to the international literature on the introduction of competition and privatization rationales into healthcare systems, and based on the case of the regional health agencies, this article argues that the “disorganization” of the French healthcare sector is prey not to market fragmentation but rather to a multifaceted integration process, which creates ever-larger actors linked by dense networks of relations. This integration process is however under strong institutional constraints which limit its scope and determine its content.