Healthcare in France

From Wikipedia, the free encyclopedia

Healthcare in France is funded by compulsory national insurance. Social Security in France is calculated as a percentage of income.

Doctors and dentists establish private practices. Patients are free to choose which health provider they visit. A patient is expected to pay at the time of use, and claim up to 85% of the cost back from the state.[1]

France has a high standard of care, without shortening waiting times. The French health care system was ranked first by the World Health Organisation in 1997[2] and 2000[3], though the Cato Institute, a libertarian American think tank, criticizes the rankings' methodology.[4]

Contents

[edit] Governance

Roselyne Bachelot-Narquin, current French Minister of Health
Roselyne Bachelot-Narquin, current French Minister of Health
Main article: Minister of Health (France)

Minister of Health and Solidarity is currently a cabinet position in the government of France. The health portfolio oversees the healthcare public services and the health insurance part of the French Social Security. As French ministerial departments are not fixed and depend on the Prime Minister's choice, the Minister sometimes also has one or some of other portfolios among Work, Pensions, Family, the Elderly, Handicapped people and Women's Rights. In that case, they are assisted by junior Ministers who focusing on specific parts of the portfolio. The current Minister is Roselyne Bachelot-Narquin.

[edit] Funding

[edit] Health insurance

The entire population must pay for compulsory health insurance. The insurers are non-profit independent agencies, which are not linked to the State. An insurance premium is deducted from all employee's pay automatically, much like income tax. An employee pays 0.75% of their salary to this insurance, and their employer must pay into the scheme an amount to the value of 12.8% of the employee's salary. Those earning less than 6,600 euros per year do not have to make health insurance payments.

To allow a full reimbursement of health costs, many French employees also pay an additional voluntary premium (up to 2.5% of their salary) to a mutual insurer. In the 1960s, 30% of the population paid for supplementary health insurance. This rose to 50% of the population in the 1970s. By 2000, 85% of the population were paying privately for additional insurance coverage.[5]

[edit] CSG

In addition to the payroll contributions, a general social contribution (or social security tax) of 7.5% (known as the Contribution Sociale Generalisée or CSG is levied on employment and investment income. Most of this goes toward health insurance.[5]

[edit] Reclaiming health costs

After paying their doctor's fee (or dentistry fee), a proportion of it is claimed back. This is around 75 to 80%, but can be as much as 85%. Under recent new rules (the so-called coordinated consultation procedure [in French: parcours de soins coordonné]) General practitioners ("médecin généraliste" or "docteur") are more and more expected to act as "gate keepers" - as they do in many other nations' healthcare systems - who then refer patients to a specialist or a hospital.[5]. The incentive to go this route is financial in that expenses are reimbursed at lower rates for patients who side-track their GP and go direct to a specialist (except for dentists, gynaecologists and psychiatrists).

[edit] Health in France

As costs are borne by the patient and then later reclaimed, patients have a freedom of choice when determining where to receive their care. [5]

Around 65% of hospital beds in France are provided by public hospitals, with around 15% provided by private non-profit organizations, and 20% by for-profit companies.[5]


The French healthcare system is one of the leading systems in the world, according to the World Health Organization.[2]

It is almost entirely free for people affected by chronic diseases ("Affections de longues durées") such as cancer, AIDS or cystic fibrosis. Average life expectancy at birth is 79.73 years.

As of 2003, there are approximately 120,000 inhabitants of France who are living with AIDS [6]

[edit] Médecin généraliste

Main article: General practitioner#France

In France, the médecin généraliste (commonly called docteur) is responsible for the long term care in a population. This implies prevention, education, care of the diseases and traumas that do not require a specialist, and orientation towards a specialist when necessary. They also follow the severe diseases day-to-day (between the acute crises that require the intervention of a specialist).

They have a role in the survey of epidemics, a legal role (consultation of traumas that can bring compensation, certificates for the practice of a sport, death certificates, certificates for hospitalization without consent in case of mental incapacity), and a role in emergency care (they can be called by the samu, the French emergency medical service). They often go to a patient's home when the patient cannot come to the consulting room (especially in case of children or old people), and have to contribute to night and week-end duty (although this was contested in a strike in 2002).

[edit] Public health

See also: Water supply and sanitation in France

France, as all EU countries, is under an EU directive to reduce sewage discharge to sensitive areas. As of 2006, France is only 40% in compliance with this directive, placing it as one of the lowest achieving countries within the EU with regard to this wastewater treatment standard [7]

[edit] See also

[edit] References

  1. ^ Grolier Multimedia Encyclopedia, 1997
  2. ^ a b the ranking, see spreadsheet details for a whole analysis.
  3. ^ French health care 'best in world'. bbc.co.uk (2000-06-21). Retrieved on 2008-03-13.
  4. ^ World Health Report Rankings Driven by Ideology, Skewed Data. Cato Institute (February 26, 2008).
  5. ^ a b c d e David G. Green and Benedict Irvine (December 2001). Health Care in France and Germany. Civitas.
  6. ^ France HIV/AIDS - people living with HIV/AIDS. Index Mundi (2007-04-17). Retrieved on 2008-03-13.
  7. ^ Water - a precious resource. European Environment Agency (2004). Retrieved on 2008-03-13.
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