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“RMO’s” (“Opposable medical references”) have for a long time been presented as the key factors for controlling expenditure on health. An investigation into the implementation of the “RMO system” leads one to note that, four years after its entry into force, it has not modified deviating medical practices, and it has not met its objectives in financial regulation terms. The article presents three reasons likely to explain this failure: I– the diverging orientations which separate the work of the legislator from the activities of those who have to make work the measures decided on; 2- the difficulty of laying down effectively controllable prescriptions in care matters; and, 3- indecision about the nature of policies for controlling health expenditure: administrative control or self-regulation by the health professionals.