Patients to Pay More for Health Care

Patients are going to have to pay more for health care services, as the French Government seeks to stem the rise in the health budget deficit. One of the main planks of the reform will be to ask the voluntary health insurers to pick up more of the costs, which is inevitably going to lead to an increase in the level of insurance premiums. President Sarkozy forewarned of this prospect last September when he stated he wanted un grand débat sur le financement de la santé and posed the question, ‘What should be financed by the State, and what should be the responsibility of the individual?’ In France, the State picks up only around 70% of medical treatment charges, so you need to take out voluntary (‘top-up’) insurance to pay the balance, or fund it directly from your pocket. Most people choose to take out voluntary insurance through a mutuelle or private health insurer, whose health insurance premiums you pay in addition to the normal social security health contributions (although EU expats of retirement age get free State health cover).

It seems possible that the Government will reduce the level of the percentage contribution it will reimburse, at least for some medications.

In other cases it is possible that the State contribution might be removed altogether. Thus, sources in the French health ministry suggest that they are examining the 750transfer to the voluntary insurers of all dental and optical charges, thermal and homeopathic treatments. As these treatments already only receive a small percentage contribution from the State, it may not mean a lot to most people, and it is likely that those on very small incomes will continue to be protected. The Government is also examining how to control the medical costs of those suffering from a major medical condition (Affections de Longue Durée). At the present time, all medical charges associated with the treatment of such an illness are fully reimbursed by the State, provided they are charged at the official rate. There is speculation that the Government wants to introduce measures for controlling this expenditure. The Government is also examining a possible reduction in sickness benefit allowance, which costs around €5 billion a year, with around €1 billion of that on sickness of a short duration. It may well ask either employers or the voluntary insurers to play a bigger role in picking up the sickness benefit costs of those who are on sickness absence for only a short period. At the present time, employers take responsibility for the first four days of sickness, whereas in most other European countries the employer is responsible for the first seven days. Whilst at the moment all of this is only speculation, the Government is committed to a substantial reduction in the level of the national debt by 2012 and the Minister of Health recently hinted that savings needed to be made. As tax increases have been ruled out, the almost inevitable consequence is that patients will need to pick up a greater proportion of the costs. Whether the health professionals, voluntary insurers, and trade unions accept the proposals remains to be seen. You can read more about health charges and health insurance in our comprehensive Guide to Health Services in France

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