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The role of unions as regards health insurance mainly concerns two different areas: the governance of the system, the major unions being traditionally represented in the bodies responsible for managing the funds, and the regulation of the system, the relations between healthcare professions and health insurance bodies being governed by agreements signed by the bodies and unions representing healthcare professions. One might think that the question of union representation would be raised in more or less similar terms in both areas. Not so. In actual fact, a comparison of the texts with their practical implementation clearly reveals that it is only in the context of conventional relationships that this question has any meaning and scope. In terms of the governance of the system, union representation is nowadays of little or no interest.