The French Health Care System

Who Pays for it?

Reasons to Emulate

• Mandatory taxes
• Employees, Employers, and Self-employed
• Government Subsidies
• Those that seek care

• #1 in the World according to the WHO
• Over 90% Enrolment
• Acceptance

The French health care system is funded by a mandatory tax levied against the salaries of every citizen. The government also provides some of the funding for the program with earmarked taxes and from the general tax fund. Each individual that seeks care must pay a small portion of the cost of some procedures, however there are exemptions for children, the poor, and those with chronic health conditions or that are disabled.

According to the World Health Organization’s World Health Report, published in 2000 when judged objectively the French health care system is rated number one in the world. To put this in perspective the US health care system was rated number 37.

Unlike in the US in France the over 90% of its citizens are enrolled in the public health care system.

Despite some of the problems with the system all most all French citizens understand the benefits of the system far outweigh the cost and that it needs to be maintained.

Accessibility

• Primary Care
• Specialized Care
• Emergency Care
• Hospital Care
• Pharmaceuticals

French citizens can choose any general practitioner that they want for their primary care needs and the cost is 23 Euros, a little under $25 in United States, with a maximum charge of 50 euros for after hours or weekend visits. However all but 6 euros is refunded by the national insurance (The Common Wealth Fund, 2013). This reimbursement method applies to specialists as well as long as the individual has been referred to the specialist by their GP. Although this is the preferred process the French do not need to have a referral in order to see a specialist, if they are willing to pay the cost without being refunded they may see any doctor they chose regardless of the type of practice.

Emergency services like EMS care or ambulance transportation are also covered under this statutory health insurance system (Rodwin, 2003). French hospitals are divided into two categories state run and privately run, most of these regardless of their affiliation are covered by the national care plan and only charge their patients what would amount to $19 a day for care, with the rest of the charge being absorbed by the state insurance. When it comes to pharmaceuticals the national insurance reimbursement system changes slightly. When a French citizen needs to fill a prescription instead of paying the full charge and waiting to be reimbursed they simply pay their portion of the fee to the pharmacist.

Problem with the System

• Financial Strain

The largest problem with the system is that often times the taxes levied against the salaries of the people are not enough to cover the cost of the program on their own. The system is often more and more dependent not only on the taxes that are earmarked for it but also on additional funding from general taxes.

The French Health Care System

References

The Common Wealth Fund. (2013) International Profiles of Health Care Systems, 2013.

Rodwin, V. G. (2003). The Health Care System Under French National Health Insurance: Lessons for Health Reform in the United States. American Journal of Public Health, 93(1), 31–37.

World Health Organization. (2000) The World Health Report 2000 Health Systems: Improving performance. The World Health Organization retrieved from http://www.who.int/whr/2000/en/whr00_en.pdf

Leah McGrath