| Overview | | | | and more than 60% of cancer cases. In all |
| | | | hospitals, doctors, biologists, and dentists |
| Current population in France is about 62 | | | | are all paid as "hospital practitioners." |
| million. If overseas territories are | | | | This combination of public and private |
| included, the entire population is about 64 | | | | medical services produces a health care |
| million. Average income per capita is | | | | system that is open to all and provides the |
| US$36,550. Top income tax rate is a little | | | | latest in medical technology. Waiting lists |
| over 48 percent. | | | | for surgeries found in other socialized |
| | | | healthcare systems do not exist in France. |
| Under the law of universal coverage called la | | | | |
| Couverture maladie universelle, The French | | | | Medical treatments from a routine visit to a |
| government provides mostly free health | | | | GP to major surgical procedures have a tarif |
| insurance through its Social Security Program | | | | (cost). Medical practitioners, hospitals & |
| (Sécurité sociale). About 96% of French | | | | clinics that adhere to this tarif are defined |
| people are covered under the system. Private | | | | as conventioné; those that do not are |
| insurance provides supplemental coverage; | | | | defined as non-conventioné and can charge |
| more than 85 percent of the people have | | | | more. Vast majority of practitioners (around |
| supplemental insurance, often through their | | | | 97%) are conventioné, and even a private |
| employers. | | | | clinic can be conventioné. Treatments, |
| | | | whether private or public, is not free at the |
| The French healthcare system has been in | | | | point of delivery. Patients first pay the |
| place for over 60 years, and has continued to | | | | full bill (tarif) and are then reimbursed |
| evolve. The World Health Organization (WHO) | | | | later (about 10 days). Generally speaking, |
| classified it the "best health system in the | | | | Sécurité sociale refunds 70 per cent of |
| world" in its June 2000 Worldwide health | | | | the cost of a visit to a médecin traitant |
| systems comparison report. | | | | (a GP or family doctor) and most |
| | | | specialistes. |
| Coverage | | | | |
| | | | Performance |
| The Sécurité Sociale universal health | | | | |
| insurance covers for all or part of the | | | | This is the one socialized medicine system |
| healthcare needs: hospitalization, doctor | | | | which does not have the same problems as the |
| visit, preventive care, prescription drugs & | | | | rest have. Good cooperation between the |
| medical equipment, emergency care & medical | | | | public and private sectors and sufficient |
| evacuation, dental & vision. However, the | | | | availability of providers allow citizens to |
| plan covers about 70% of actual medical fees. | | | | avoid waiting lists for diagnosis, surgeries |
| Prescriptions are only reimbursed from 35% to | | | | and treatment. Over 65% of the people express |
| 65%. Treatment costs for long-term illnesses | | | | satisfaction with their system. |
| are fully reimbursed. There is compensation | | | | |
| in the case of pregnancy. | | | | People can choose among healthcare providers, |
| | | | regardless of their income level. They can |
| In addition, supplemental health Insurance | | | | consult a variety of doctors and specialists |
| plans, generally referred to as a "Top-Up" | | | | or choose a public, private, university or |
| policy or assurance complémentaire, sold | | | | general hospital. |
| by private insurance companies, are in place | | | | |
| to complement the Social Security's coverage. | | | | Current life expectancy in France is 80.7, |
| There are a wide variety of providers | | | | with French women having the second highest |
| offering an extensive range of plans and | | | | life expectancy in the world. The World |
| premium schedules to meet individual | | | | Health Organization (WHO) classified the |
| circumstances. | | | | French system the "best health system in the |
| | | | world" in June 2000. |
| Funding | | | | |
| | | | Deficiency |
| Most of the funds come from social security | | | | |
| taxes on salary and income. Employers pay | | | | Even the best health care system in the world |
| 12.8% on employees' total gross salary, while | | | | has its own set of problems. Because of the |
| employee adds in 0.75%. Another tax called | | | | high level of reimbursement and coverage, |
| General Social Contribution (CSG) introduced | | | | French health care is among the most |
| in 1991 helps to reduce shortfalls. It is | | | | expensive in the world. Its budget is the |
| 7.5%, calculated from 95% of the gross | | | | world's third largest, accounting for 11% of |
| salary. The CSG is inclusive all income, as | | | | GNP. Rising costs and aging population make |
| well as the income of capital and property. | | | | it a struggle for France to finance this |
| Taxes on alcohol and tobacco also contribute | | | | system. If spending continues at the current |
| to the overall funding. | | | | rate, the health service may be 70 billion |
| | | | Euros in debt by the end of 2020. |
| Actual budget varies according to revenue | | | | |
| earned through taxes each year. But rising | | | | Waste is another problem within the system. |
| costs has caused the system running constant | | | | Sources suggest that patients "shop" for |
| deficits since 1985, which has ballooned to | | | | doctors, visiting multiple specialists until |
| over $14 billion and continues to grow. In | | | | they receive the diagnosis they want. One |
| 2004, French people spend $3,500 Per-capita | | | | fifth of the country's health spending goes |
| on health care. That's around 10.7% of their | | | | to pharmaceuticals due to overuse of |
| GDP. | | | | prescription drugs. |
| | | | |
| The French system is often categorized as a | | | | Doctors Without Borders organization |
| mixed system in which public and private | | | | estimates that over 300,000 people in France |
| provision and funding co-exist. Private | | | | are now without health-care coverage under a |
| health insurance is more important in France | | | | universal health care system. |
| than in any other European countries. | | | | |
| | | | Reform |
| Delivery | | | | |
| | | | French reformers' first priority is to move |
| There are two large organizations that work | | | | health insurance financing away from payroll |
| under the Ministry of Health: General Health | | | | and wage levies because they hamper |
| Management and Hospital & Healthcare | | | | employers' willingness to hire. Instead, |
| Management, under which there are three types | | | | France is turning toward broad taxes on |
| of health care facilities and agencies, which | | | | earned and unearned income alike to pay for |
| are public hospitals, private clinics and | | | | health care. |
| not-for-profit healthcare centers. | | | | |
| | | | The debates on how to balance the budget and |
| There are 1,032 hospitals under the public | | | | avoid deficits have been ongoing without |
| hospital statute. Regional, university, local | | | | acceptable solutions. |
| and general hospitals are included in this | | | | |
| category. There are 2,139 private for profit | | | | Efforts by the administration to control |
| and not-for-profit healthcare facilities | | | | costs by cutting overly rich benefits and by |
| actively treating more than 50% of surgeries | | | | managing waste have met stiff resistance. |