French Healthcare System Overview

Introduction

• French healthcare system admired globally.
• Post-WWII need led to establishment in 1945.
• Known as Social Security in France.
• Mandatory health insurance for all.

Structure of the System

• Insurance obtained from non-profit funds.
• Five main funds: General, Independent, Agricultural, Student, and Public Service.
  • General Fund covers nearly 85% of people.
• Government plan for those not covered by funds, especially the very poor.

Funding

• Largely financed by public sources:
  • 40% from payroll taxes.
  • 33% from income taxes.
  • Remainder from tobacco, alcohol taxes, and state subsidies.
• Covers more than 3/4 of healthcare spending.

Coverage

• Encompasses inpatient/outpatient care, specialists, dental, midwives, diagnostics, drugs, devices, mental health, and even transportation.
• Includes unusual coverage (for the US) like homeopathy, house calls, maternity benefits, and childcare.
• Social Security covers 70-80% of costs.
• Voluntary insurance covers remaining costs; over 90% have it, usually job-based.

Healthcare Providers

• Majority of physicians are self-employed.
• Two-thirds of hospital beds managed by public or non-profit, the rest by for-profits.
• Doctors earn less than US counterparts but benefits include free medical school and no malpractice insurance.

Regulation and Policies

• Ministry of Health oversees funding, equipment purchase, medical training, prices, and priorities.
• Agreements between Social Security and unions; doctors can work outside it and charge more.
• Patients have total freedom in choosing providers.

Costs and Copays

• Doctor visits can cost €1 or less; hospital stays €18/day; prescriptions around €0.5.
• Annual cap on costs around €50.
• Chronic illness patients have copays waived.

Access and Satisfaction

• High access assurance, especially for cancer medications.
• High satisfaction and quality rankings in international surveys.
• Criticized for expense, but less than US costs.

Economic Considerations

• High spending per person but not excessive compared to US.
• 11.6% of GDP spent on healthcare.
• Comprehensive benefits and universal coverage are highlights.

Conclusion

• French system praised for universal and comprehensive care.
• Regarded as one of the best healthcare systems globally.