Journal article: This article describes the state of affairs in the French healthcare system before the SARS-CoV-2 pandemic and explains the logic behind the “reforms” of the last twenty years. We explain activity-based costing (T2A) and outline its origins, its advantages, and its limits within the context of spending restrictions called for by the National Health Insurance Expenditure Target (ONDAM). We then turn to the situation in psychiatry. The economic weight of psychiatry makes it necessary to regulate expenditure. However, the types of patient care involved in psychiatry conflict with the very logic of activity-based costing, since it is a medical activity that is inseparable from outpatient care as part of a patient care pathway. Our article then demonstrates the implications of the shift toward outpatient care and ambulatory healthcare pathways in the social, medico-social, and care sectors. What has taken place in psychiatry is used as an example to depict the complexities involved in this shift. This article then discusses the burden that this shift places upon carers, as we move from hospital care to care pathways, and from hospitals as producers of care to hospitals as a factor in the health of a population. Then, with emphasis on the great upheaval that the French healthcare system is currently undergoing, the article describes the adaptations that actors within the system are making in order to deal with the pandemic. It thus seeks to draw some lessons and perspectives from the health crisis. The article concludes on the importance of structuring care along a continuum, from general practitioner to hospital and back again, so as to provide continuity of care for the patient.