Healthcare in France - Health Care System

Health Care System

The entire population must pay compulsory health insurance. The insurers are non-profit agencies that annually participate in negotiations with the state regarding the overall funding of health care in France. There are three main funds, the largest of which covers 84% of the population and the other two a further 12%. A premium is deducted from all employees' pay automatically. The 2001 Social Security Funding Act, set the rates for health insurance covering the statutory health care plan at 5.25% on earned income, capital and winnings from gambling and at 3.95% on benefits (pensions and allowances).

After paying the doctor's or dentist's fee, a proportion is reimbursed. This is around 75 to 80%, but can be as much as 85%. The balance is effectively a co-payment paid by the patient but it can also be recovered if the patient pays a regular premium to a voluntary health insurance scheme. Nationally, about half of such copayments are paid from VHI insurance and half out of pocket.

Under recent rules (the coordinated consultation procedure, in French: "parcours de soins coordonné"), general practitioners ("médecin généraliste" or "docteur") are expected to act as "gate keepers" who refer patients to a specialist or a hospital when necessary. However the system offers free choice of the reference doctor, which is not restricted to only general practitioner and may still be a specialist or a doctor in a public or private hospital. The goal is to limit the number of consultations for the same illness. The incentive is financial in that expenses are reimbursed at much lower rates for patients who go directly to another doctor (except for dentists, ophthalmologists, gynaecologists and psychiatrists); vital emergencies are still exempt from requiring the advice from the reference doctor, which will be informed later. As costs are borne by the patient and then reimbursed, patients have freedom of choice of where to receive health care services.

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

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