Last night I followed an invitation by Professor Étienne Minvielle to speak in front of France’s senior hospital executives (“Les hautes dirigeants des hôpitaux de la France” – almost everything sounds much better in French) about my international experiences with designing and implementing incentive systems. The current environment in France is in flux and the thinking circles around adding selective monetary incentives (“Pay-for-Performance – P4P”) like in many countries. But do we get what we pay for if we follow this path and haven’t other countries, such as the US and Germany tried this out as well? Yes, they have. And was it a success. We don’t know. But why don’t we know?