france health insurance 2022
In the wake of the pandemic, there has been an increase in the incidence and severity of chronic conditions such as diabetes and hypertension. These diseases have become more common across many population segments of countries around the world and it is projected that, by 2030, approximately 350 million people in European Union will be living with one or more chronic conditions2. The health care system in other countries has been overwhelmed and this means that more patients are getting sicker. This situation can be expected to worsen as time goes on and more people are being admitted to hospitals3.
The need for a sustainable health care system
To address these challenges, governments should prioritize ensuring that health services are available to all people who need them and are able to afford them. Governments must ensure that funding of health care is protected from cuts introduced by various factors such as increased taxation, lack of political will, changes in legislation, and lack of accountability.4 Countries and institutions should look at ways in which they could make public support for their health care systems more predictable and reliable.5
This article explores how France’s healthcare system operates, and what would the effects of not having high social protection. It also describes some approaches other countries may consider if making similar decisions. Finally, we will discuss France’s recent experiences that impact its current position with respect to health insurance.
France is already experiencing a period of economic and financial recovery in 20206. Despite this, the country still faces multiple issues in terms of access to health care, which has led to concern among healthcare professionals about the sustainability of the French healthcare system.7 While France has made significant progress in terms of increasing health budgets, the state remains insufficiently prepared for the future needs of a growing population and aging population8
The main goal of the current paper is to explore the importance of proper health insurance reforms in relation to the current state of the French healthcare system, with particular focus on France’s upcoming discussions on reforming its health insurance program. As part of this, we will compare the benefits and costs of several forms of health insurance coverage such as private, public and family plans. We will also review the role of administrative and budgetary pressures in the development of health insurance policies.
France’s System Overview
France’s healthcare system comprises three levels: national healthcare, regional networks, and primary care. National health insurance is the responsibility of the federal government, the Ministry of Health (Ministère de la Planification et des Services Publics) and the General Directorate of Primary Care (DGPC).9
On the regional level, there is the Paris Fondation de Recherche Territoriale (PRR), the Fondation du Contre-Etat et de l’Etat Territorial (UNICEF), and numerous smaller entities and foundations that all work together to improve health in Europe10.
France’s National Healthcare Insurance Act was founded in 1966 and established under Article 122 of the European Community Treaty, which France had ratified in 1979.11 Such act provides that each member state of the EU will have to develop a “system of universal health coverage” within its territory, meaning that the rights of people to receive quality health care and a fair reimbursement for the same12. All these activities are currently carried out by the authorities in each country under the direction of the Inter-Governmental Conference on Social Security and Health (IGC SHS)13, which is chaired by the Commission for Employment and Social Affairs (CESE).14
The national health insurance covers about 45% of the general population population and 60% of those aged over 65. It includes both voluntary and compulsory contributions, which is why national healthcare insurance has a strong influence on national economies. In addition to this, national healthcare insurance guarantees access to healthcare for all citizens.
In France, national health insurance coverage is divided into two parts: the first one is based on income, where everyone is required to pay 30 euros per person per month, regardless of his/her earnings. However, people with lower incomes do not require any medical insurance because income criteria has already been reduced since 2009, leaving only a small number of the poorest people out of the coverage.15 There are also mandatory contributions, which obliges people to contribute a certain amount of money when they visit hospitals, doctors or pharmacies, or in order to remain employed at working age.16 Additionally, mandatory contribution of € 7.6 billion was granted for families in 2019, which represents a total of 25% of the family annual income.17 These contributions, however, do not cover medical expenses.
The second part of national health insurance is the employer-sponsored plan. This is the major type of coverage that covers almost 80% of employees, while voluntary contributions cover 30-40%, including healthcare.
The employee health benefits scheme (AEHS) offers workers coverage of 80% of the monthly salary, up to a ceiling of 80 people. The contribution limit, for example, will depend on individual workers’ education, age, marital status, professions and years of experience. The fund can only be used to purchase medical insurance through AEHS, so in case of such an event, the funds for other purposes cannot be spent.
In France, the number of people registered with insurers is very large, but their needs vary a lot. This is a result of several reasons, ranging from mental illness or depression, which makes individuals more unwilling to get vaccinated, to physical issues such as back pain or hip problems. According to the Groupe Pompidou, this is due to widespread concerns about vaccination, with many companies opting for alternative arrangements such as insurance on specific illnesses that they treat.
All companies and individuals currently offer healthcare through different mechanisms such as membership in various clubs or associations. Employees also use a variety of other schemes such as free transportation to hospitals. When looking at statistics in France, it is clear that not all sectors are receiving equal healthcare.
France’s Main Factors Contributing To Its Poor Healthcare Systems
France, and especially Paris, face serious challenges when it comes to providing healthcare to all its citizens. This is mostly due to the fact that only 33% of people aged 75+ (which constitutes around half the adult labor force) receive healthcare in France.18 With that context in mind, it is evident why the national health insurance contributes nearly 50% to GDP. 19 Currently, only 21% of the population is covered by voluntary and compulsory health insurance mechanisms.20 For instance, some employers opt for insurance on pre-existing conditions, such as depression, diabetes, asthma or cancer, and most employers choose voluntary coverage, while others provide all-inclusive coverage.21
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