The entire thing becomes a giant game of "what you can bill", which pretty much sums up healthcare today. There is no emphasis on outcome, quality, or cost, just whether something is "reimburseable". Will it be covered by the ticket?
I'm curious to know if a study has been done about the similar effects of restaurant tickets. The idea seems quite plausible, would go a long way towards explaining the doubtful quality of many parisian restaurants and, anecdotally, I remember a lot of use of restaurant tickets and incentives based on them when I was in the city of lights.
P.S. Bisto food sucks. I went to Paris on my honeymoon last year, I live in SF and our food is better and way more innovate to boot.
As to bistros, well I've been to a hundred different restaurants in Paris, they don't all have 'bistro' written on the window but I'm sure that some were. For the money that I was willing to spend at the time, nothing stood out so much. The Bouillon Chartier was great since I'm a fan of the Lyon-style bouchon and I find them comparable. Generally, I wouldn't go to Paris for affordable and good food. I'm not particularly looking for innovation either, just some intelligence in the menu and ingredients.