Health Care System in France

Overview50% of surgeries and more than 60% of cancer
Current population in France is about 62 million. Ifcases. In all hospitals, doctors, biologists, and
overseas territories are included, the entiredentists are all paid as "hospital practitioners." This
population is about 64 million. Average income percombination of public and private medical services
capita is US$36,550. Top income tax rate is a littleproduces a health care system that is open to all
over 48 percent.and provides the latest in medical technology.
Under the law of universal coverage called laWaiting lists for surgeries found in other socialized
Couverture maladie universelle, The Frenchhealthcare systems do not exist in France.
government provides mostly free health insuranceMedical treatments from a routine visit to a GP to
through its Social Security Programmajor surgical procedures have a tarif (cost).
(Sécurité sociale). About 96% ofMedical practitioners, hospitals & clinics that adhere
French people are covered under the system.to this tarif are defined as conventioné;
Private insurance provides supplemental coverage;those that do not are defined as
more than 85 percent of the people havenon-conventioné and can charge more. Vast
supplemental insurance, often through theirmajority of practitioners (around 97%) are
employers.conventioné, and even a private clinic can
The French healthcare system has been in placebe conventioné. Treatments, whether
for over 60 years, and has continued to evolve.private or public, is not free at the point of
The World Health Organization (WHO) classified itdelivery. Patients first pay the full bill (tarif) and
the "best health system in the world" in its Juneare then reimbursed later (about 10 days).
2000 Worldwide health systems comparisonGenerally speaking, Sécurité sociale
report.refunds 70 per cent of the cost of a visit to a
Coveragemédecin traitant (a GP or family doctor) and
The Sécurité Sociale universal healthmost specialistes.
insurance covers for all or part of the healthcarePerformance
needs: hospitalization, doctor visit, preventive care,This is the one socialized medicine system which
prescription drugs & medical equipment,does not have the same problems as the rest
emergency care & medical evacuation, dental &have. Good cooperation between the public and
vision. However, the plan covers about 70% ofprivate sectors and sufficient availability of
actual medical fees. Prescriptions are onlyproviders allow citizens to avoid waiting lists for
reimbursed from 35% to 65%. Treatment costsdiagnosis, surgeries and treatment. Over 65% of
for long-term illnesses are fully reimbursed. Therethe people express satisfaction with their system.
is compensation in the case of pregnancy.People can choose among healthcare providers,
In addition, supplemental health Insurance plans,regardless of their income level. They can consult
generally referred to as a "Top-Up" policy ora variety of doctors and specialists or choose a
assurance complémentaire, sold by privatepublic, private, university or general hospital.
insurance companies, are in place to complementCurrent life expectancy in France is 80.7, with
the Social Security's coverage. There are a wideFrench women having the second highest life
variety of providers offering an extensive rangeexpectancy in the world. The World Health
of plans and premium schedules to meet individualOrganization (WHO) classified the French system
circumstances.the "best health system in the world" in June
Funding2000.
Most of the funds come from social securityDeficiency
taxes on salary and income. Employers pay 12.8%Even the best health care system in the world
on employees' total gross salary, while employeehas its own set of problems. Because of the high
adds in 0.75%. Another tax called General Sociallevel of reimbursement and coverage, French
Contribution (CSG) introduced in 1991 helps tohealth care is among the most expensive in the
reduce shortfalls. It is 7.5%, calculated from 95%world. Its budget is the world's third largest,
of the gross salary. The CSG is inclusive allaccounting for 11% of GNP. Rising costs and aging
income, as well as the income of capital andpopulation make it a struggle for France to
property. Taxes on alcohol and tobacco alsofinance this system. If spending continues at the
contribute to the overall funding.current rate, the health service may be 70 billion
Actual budget varies according to revenue earnedEuros in debt by the end of 2020.
through taxes each year. But rising costs hasWaste is another problem within the system.
caused the system running constant deficits sinceSources suggest that patients "shop" for doctors,
1985, which has ballooned to over $14 billion andvisiting multiple specialists until they receive the
continues to grow. In 2004, French people spenddiagnosis they want. One fifth of the country's
$3,500 Per-capita on health care. That's aroundhealth spending goes to pharmaceuticals due to
10.7% of their GDP.overuse of prescription drugs.
The French system is often categorized as aDoctors Without Borders organization estimates
mixed system in which public and private provisionthat over 300,000 people in France are now
and funding co-exist. Private health insurance iswithout health-care coverage under a universal
more important in France than in any otherhealth care system.
European countries.Reform
DeliveryFrench reformers' first priority is to move health
There are two large organizations that workinsurance financing away from payroll and wage
under the Ministry of Health: General Healthlevies because they hamper employers' willingness
Management and Hospital & Healthcareto hire. Instead, France is turning toward broad
Management, under which there are three typestaxes on earned and unearned income alike to
of health care facilities and agencies, which arepay for health care.
public hospitals, private clinics and not-for-profitThe debates on how to balance the budget and
healthcare centers.avoid deficits have been ongoing without
There are 1,032 hospitals under the public hospitalacceptable solutions.
statute. Regional, university, local and generalEfforts by the administration to control costs by
hospitals are included in this category. There arecutting overly rich benefits and by managing
2,139 private for profit and not-for-profitwaste have met stiff resistance.
healthcare facilities actively treating more than