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Health care in France
The French health care system is one of universal health care largely financed by government national health insurance. In 2017, France spent 11.3% of GDP on health care, or US$5,370 per capita, a figure higher than the average spent by rich countries (OECD average is 8.8%, 2017), though similar to Germany (10.6%) and Canada (10%), but much less than in the US (17.1%, 2018). Approximately 77% of health expenditures are covered by government-funded agencies.
Most general physicians are in private practice but draw their income from the public insurance funds. These funds, unlike their German counterparts, have never gained self-management responsibility. Instead, the government has taken responsibility for the financial and operational management of health insurance (by setting premium levels related to income and determining the prices of goods and services refunded). The French government generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers. Until 2000, coverage was restricted to those who contributed to social security (generally, workers or retirees), excluding some poor segments of the population. The government of Lionel Jospin put into place universal health coverage and extended the coverage to all those legally resident in France. Only about 3.7% of hospital treatment costs are reimbursed through private insurance, but a much higher share of the cost of spectacles and prostheses (21.9%), drugs (18.6%) and dental care (35.9%) (figures from the year 2000). There are public hospitals, non-profit independent hospitals (which are linked to the public system), as well as private for-profit hospitals.
The French Third Republic followed well behind Bismarckian Germany, as well as Great Britain, in developing the welfare state including public health. Tuberculosis was the most dreaded disease of the day, especially striking young people in their 20s. Germany set up vigorous measures of public hygiene and public sanatoria, but France let private physicians handle the problem, which left it with a much higher death rate. The French medical profession jealously guarded its prerogatives, and public health activists were not as well organized or as influential as in Germany, Britain or the United States. For example, there was a long battle over a public health law which began in the 1880s as a campaign to reorganize the nation's health services, to require the registration of infectious diseases, to mandate quarantines, and to improve the deficient health and housing legislation of 1850. However the reformers met opposition from bureaucrats, politicians, and physicians. Because it was so threatening to so many interests, the proposal was debated and postponed for 20 years before becoming law in 1902. Success finally came when the government realized that contagious diseases had a national security impact in weakening military recruits, and keeping the population growth rate well below Germany's.
The current system has undergone several changes since its foundation in 1945, though the basis of the system remains state planned and operated.
Jean de Kervasdoué, a health economist, believes that French medicine is of great quality and is "the only credible alternative to the Americanization of world medicine." According to Kervasdoué, France's surgeons, clinicians, psychiatrists, and its emergency care system (SAMU) are an example for the world. However, despite this, Kervasdoué criticizes the fact that hospitals must comply with 43 bodies of regulation and the nit-picking bureaucracy that can be found in the system. Kervasdoué believes that the state intervenes too much in regulating the daily functions of French hospitals.
Furthermore, Japan, Sweden, and the Netherlands have health care systems with comparable performance to that of France's, yet spend no more than 8% of their GDP (against France's spending of more than 10% of its GDP).
According to various experts,[who?] the battered state of the French social security system's finances is causing the growth of France's health care expenses. To control expenses, these experts[who?] recommend a reorganization of access to health care providers, revisions to pertinent laws, a repossession by CNAMTS (French acronym: Caisse Nationale d'Assurance Maladie des Travailleurs Salariés or National Health Insurance Fund for Salaried Workers) of the continued development of medicines, and the democratization of budgetary arbitration to counter pressure from the pharmaceutical industry.
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).
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Health care in France
The French health care system is one of universal health care largely financed by government national health insurance. In 2017, France spent 11.3% of GDP on health care, or US$5,370 per capita, a figure higher than the average spent by rich countries (OECD average is 8.8%, 2017), though similar to Germany (10.6%) and Canada (10%), but much less than in the US (17.1%, 2018). Approximately 77% of health expenditures are covered by government-funded agencies.
Most general physicians are in private practice but draw their income from the public insurance funds. These funds, unlike their German counterparts, have never gained self-management responsibility. Instead, the government has taken responsibility for the financial and operational management of health insurance (by setting premium levels related to income and determining the prices of goods and services refunded). The French government generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers. Until 2000, coverage was restricted to those who contributed to social security (generally, workers or retirees), excluding some poor segments of the population. The government of Lionel Jospin put into place universal health coverage and extended the coverage to all those legally resident in France. Only about 3.7% of hospital treatment costs are reimbursed through private insurance, but a much higher share of the cost of spectacles and prostheses (21.9%), drugs (18.6%) and dental care (35.9%) (figures from the year 2000). There are public hospitals, non-profit independent hospitals (which are linked to the public system), as well as private for-profit hospitals.
The French Third Republic followed well behind Bismarckian Germany, as well as Great Britain, in developing the welfare state including public health. Tuberculosis was the most dreaded disease of the day, especially striking young people in their 20s. Germany set up vigorous measures of public hygiene and public sanatoria, but France let private physicians handle the problem, which left it with a much higher death rate. The French medical profession jealously guarded its prerogatives, and public health activists were not as well organized or as influential as in Germany, Britain or the United States. For example, there was a long battle over a public health law which began in the 1880s as a campaign to reorganize the nation's health services, to require the registration of infectious diseases, to mandate quarantines, and to improve the deficient health and housing legislation of 1850. However the reformers met opposition from bureaucrats, politicians, and physicians. Because it was so threatening to so many interests, the proposal was debated and postponed for 20 years before becoming law in 1902. Success finally came when the government realized that contagious diseases had a national security impact in weakening military recruits, and keeping the population growth rate well below Germany's.
The current system has undergone several changes since its foundation in 1945, though the basis of the system remains state planned and operated.
Jean de Kervasdoué, a health economist, believes that French medicine is of great quality and is "the only credible alternative to the Americanization of world medicine." According to Kervasdoué, France's surgeons, clinicians, psychiatrists, and its emergency care system (SAMU) are an example for the world. However, despite this, Kervasdoué criticizes the fact that hospitals must comply with 43 bodies of regulation and the nit-picking bureaucracy that can be found in the system. Kervasdoué believes that the state intervenes too much in regulating the daily functions of French hospitals.
Furthermore, Japan, Sweden, and the Netherlands have health care systems with comparable performance to that of France's, yet spend no more than 8% of their GDP (against France's spending of more than 10% of its GDP).
According to various experts,[who?] the battered state of the French social security system's finances is causing the growth of France's health care expenses. To control expenses, these experts[who?] recommend a reorganization of access to health care providers, revisions to pertinent laws, a repossession by CNAMTS (French acronym: Caisse Nationale d'Assurance Maladie des Travailleurs Salariés or National Health Insurance Fund for Salaried Workers) of the continued development of medicines, and the democratization of budgetary arbitration to counter pressure from the pharmaceutical industry.
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).