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Health Care System in France 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. 1 A B C D 58 59 60 61 62 63 64 66 67 68 69 70 71 72 74 75 76 77 78 79 80 81 84 85 87 88 89 91 92 94 95 96 97 98 99 100 101 102 103 104 106 107 108 109 110