Health care in France is arguably the best in the world. For years, the World Health Organization (WHO) published an index rating and ranking the quality of health care in every country in the world. Year after year France came out on top.
And, if you’re a member of French Social Security (that is, you’re paying into the system), most of the cost of this extraordinary health care is covered.
The remaining cost for your treatment or medicines (including fees for doctors who are non-conventionnés, dental, and optical care) can be covered by joining a top-up health insurance, called complémentaire sanité. In this category, you have the choice between an assurance and a mutuelle. This type of additional insurance will pay most, but not all of the residual costs, depending on your policy, circumstances, and treatment.
Generally, non-EU residents will not be able to access the public health care system and will need to seek private care.
The Ministry of Health coordinates health care in France and their system is widely regarded as one of the best in the world. Why it works so well is because it is a fully integrated system meaning that public and private hospitals, as well as doctors and other medical professionals, recognize and accept the plan. Every citizen is covered and little effort has to be expended to take advantage of the coverage.
People signing up for coverage have the ability to choose any general practitioner they wish. If they should find themselves in another part of the country when they fall sick, they are able to go to another doctor without incurring any hassles. In the event that the patient needs to see a specialist, their own doctor would be the only one able to give them a referral. The out of pocket expense for a doctor’s visit would be about 23 Euros with most of that being reimbursed by the citizen’s personal insurance conduit. Across the country, rates for medical services are fixed and agreed upon by medical professionals, so there is no competition or price gouging.
All in, it is a very uncomplicated system with no guesswork involved.
Working individuals are required to pay around 8% of their income into national health care costs. Employers pay around 13% of their total salaries into the system as well. Beyond that, the government and small contributions from the patient make up the rest of the cost. It’s important to note that this system covers everyone regardless of employment status.
These two systems could not be more different. French citizens have had the benefit of their current system, in some form, since 1945. This means that most people have grown into the workforce with these tax rates as the standard. For these citizens, the expense has always been there, so there is no sticker shock and therefore they are happy to pay for the benefits.
In the United States, however, the guise of choice has been the calling card for the past forty years. In this system, people ask why it’s fair for a citizen to pay so much into a system if they are healthy and will not use it. Although this argument creates households with more disposable income, it has also created a mindset in people who choose not to go to a doctor even if they probably should.
What the US system does have over the French system is prompt services. With less people requesting services, there is little wait time. With the institution of the Affordable Health Care Act more people are flooding into hospitals and wait times for services have grown to months. That is unless you have the money and are paying higher premiums for better service.
Pharmaceuticals in the United States are extremely expensive because of price gauging by ‘Big Pharm’. Recently, one company started charging over $600 for EpiPens, which brought the ire, but no real action was taken. In France, pharmaceuticals are covered by the French health care system, with very little out of pocket expense for the patient.
The major flaw in the American system is that the health insurance companies pretty much run the show. Citizens must sift through books that detail the different plans they can purchase and it really is a guessing game where you have to roll the dice and hope the plan you choose covers whatever ailment pops up in the future.
The flaw with the French plan is the aging population. As more people leave the workforce, the burden of paying for their care falls on the next generation, which is smaller. The government is having to pick up a bigger portion of the nation’s health care costs and resources are becoming strained.
With health care in France being such a magnanimous system, the country experiences influxes of immigrants looking to avail themselves of the services. The strain became so great that the country had to establish some restrictions on immigrants. To restrict immigrants, making a five-year residency a requirement before the health care benefits could be used.
This rule was overturned for members of the European Union, when it was deemed that it conflicted with EU rules about travel within the countries of the EU. Since the state of the EU is currently in flux with waves of nationalism spreading across the world, one can expect France to seek new rulings from the EU if it is expected to offer health care to every European, who wishes to move to France.
When moving to France from countries outside of Europe, you will have to register with the local town council. They will ask you to prove that you will be a contributing, viable citizen. You will be required to provide your own health insurance for five years unless you reach retirement age within that time period. Once these time requirements are met, you become eligible.
Insurance policies purchased by people who are not residents of France (or the European Union) are called ‘Top Up’ insurance. These are insurance policies designed to cover costs not already covered by the French health care setup. With these policies, the government sets a cost for procedures and the top up insurance will cover up to that amount.
The health care system in France has been growing and changing for decades and is currently regarded as one of the best systems in the world. By taking the business, money making angle out of health care, France created a system that is coveted by citizens around the world. Other developed nations would serve their citizens well by looking at what France has done and deciding what parts of the system could work best for their countries.