Guide to French Health System

Welcome to our guide to the health system in France.

France is often rightly praised for the quality of healthcare it provides.

The country certainly spends a lot of money on health, around 10% of gross national income, one of the highest rates in the world.

Perhaps as a result of this expenditure the French enjoy a life expectancy only exceeded by that of the Japanese!

Nevertheless, the system is under severe financial pressure, there is a growing shortage of suitable staff in many regions, and an increasing proportion of the running costs are having to be picked up by patients.

At an institutional level the organisation and financing of the system is complex and is often characterised by high levels of tension between the system's various parts.

Most health professionals who work outside of hospitals are self-employed and depend for their income on fee paying patients whose costs are reimbursed by the social security and voluntary health insurance systems.

Patients, in turn, have been allowed unrestricted access to doctors and specialists, with the result that no-one in the health system has had any particular incentive to keep down costs.

Over the past few years the government has introduced a series of reforms, the whole purpose of which is to increase efficiency and drive down costs. These reforms are on-going.

Social charges have been increased, as have fees for medical consultations, whilst reimbursement levels have been reduced for certain treatments.

At an administrative level everyone is now required to register with a doctor to obtain the full level of reimbursement, medical records for patients are to be introduced, and there have been some reforms to the institutional structure.

Continuing concern about rising costs has resulted in more stringent government stronger controls limiting the freedom of professionals and patients and to constrain the price of medicines.

To anyone from outside of France, some of these reforms may appear logical and long overdue, but there is widespread concern in France about their impact.

Many health professionals consider the changes to be too bureaucratic, and there are many commentators who consider that the costs of health care are going to increasingly fall upon poorer members of the community and those who are ill.

In short, like most other developed nations, France can no longer afford its health service.

You can find details of how the system works, and how you obtain health cover in France, in the following pages.