Healthcare in France

Healthcare in France is funded by compulsory national insurance. Social Security in France is calculated as a percentage of income.

Doctors and dentists establish private practices. Patients are free to choose which they visit. A patient is expected to pay and claim up to 85% of the cost from the state.Grolier Multimedia Encyclopedia, 1997]

France has a high standard of care. The health system was ranked first by the World Health Organisation in 1997cite web|url=http://www.photius.com/rankings/healthranks.html|title=the ranking, see spreadsheet details for a whole analysis] and 2000cite web|url=http://news.bbc.co.uk/hi/english/health/newsid_799000/799444.stm|title=French health care 'best in world'|date=2000-06-21|accessdate=2008-03-13|publisher=bbc.co.uk] .

Governance

Minister of Health and Solidarity is a cabinet position in the government of France. The health portfolio oversees the healthcare 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. The current Minister is Roselyne Bachelot-Narquin.

Funding

Health insurance

The entire population must pay compulsory health insurance. The insurers are non-profit independent agencies not linked to the State. A premium is deducted from all employees' pay automatically. An employee pays 0.75% of salary to this insurance, and the employer pays an amount to the value of 12.8% of the employee's salary. Those earning less than 6,600 euros per year do not make health insurance payments.

To allow full reimbursement of health costs, many employees also pay a voluntary premium (up to 2.5% of salary) to a mutual insurer. In the 1960s, 30% of the population paid for supplementary health insurance. This rose to 50% in the 1970s. By 2000, 85% of the population were paying privately for additional insurance coverage.cite web|title=Health Care in France and Germany|author=David G. Green and Benedict Irvine|publisher=Civitas|url=http://www.civitas.org.uk/pdf/cs17.pdf|date=December 2001]

CSG

In addition to payroll contributions, a general social contribution (or social security tax) of 7.5% (known as the "Contribution Sociale Generalisée" or "CSG") is levied on employment and investment income. Most goes to health insurance.

Reclaiming health costs

After paying the doctor's or dentist's fee, a proportion is claimed back. This is around 75 to 80%, but can be as much as 85%. Under recent rules (the coordinated consultation procedure [in French: parcours de soins coordonné] ) General practitioners ("médecin généraliste" or "docteur") are more expected to act as "gate keepers" who refer patients to a specialist or a hospital.. The incentive is financial in that expenses are reimbursed at lower rates for patients who go direct to a specialist (except for dentists, gynaecologists and psychiatrists).

Health in France

As costs are borne by the patient and then reclaimed, patients have freedom of choice where to receive care.

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.

The healthcare system is one of the leading systems in the world, according to the World Health Organization.

It is almost entirely free for people affected by chronic diseases ("Affections de longues durées") such as cancer, AIDS or cystic fibrosis. Average life expectancy at birth is 79.73 years.

In 2003, there were approximately 120,000 inhabitants of France living with AIDS cite web|url=http://www.indexmundi.com/france/hiv_aids_people_living_with_hiv_aids.html|title=France HIV/AIDS - people living with HIV/AIDS|publisher=Index Mundi|accessdate=2008-03-13|date=2007-04-17]

"Médecin généraliste"

The "médecin généraliste" (commonly called "docteur") is responsible for long-term care in a population. This implies prevention, education, care of diseases and traumas that do not require a specialist. They also follow severe diseases day-to-day (between acute crises that require a specialist).

They survey epidemics, a legal role (consultation of traumas that can bring compensation, certificates for the practice of a sport, death certificates, certificates for hospitalization without consent in case of mental incapacity), and a role in emergency care (they can be called by the "samu", the emergency medical service). They often go to a patient's home when the patient cannot come to the consulting room (especially in case of children or old people), and have to contribute to night and week-end duty.

Public health

France, as all EU countries, is under an EU directive to reduce sewage discharge to sensitive areas. In 2006, France was only 40% in compliance, one of the lowest achieving countries in the EU with regard to this wastewater treatment standard cite web|url=http://epaedia.eea.europa.eu/page.php?pid=501|title=Water - a precious resource|publisher=European Environment Agency|date=2004|accessdate=2008-03-13]

ee also

*Abortion in France
*Emergency medical services in France
*Emergency medicine in France
*List of hospitals in France
*Minister of Health (France)
*Paramedics in France
*SAMU
*Social Security in France

References