French Health Care Plan
Often identified and simplified as a socialistic structure, the French health care plan is actually fairly complex. In fact, its creators gave it a more privatized role than that of systems in other nations sicj as Britain or Cuba. Because France's plan stands as an example to countries undecided about the paths of their own health care system, understanding it is key.
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Mix Between Public and Private
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In France, the state controls certain major aspects of the health care system. It ensures that everyone is covered, it dictates which procedures are reimbursed and by how much, it oversees patient rights, and determines the size, number, and equipping of public hospitals. Yet, while 65 percent of the hospitals in France are public, private hospitals also exist. These don't provide any better quality of care but are geared towards profit and deal mostly in surgery while the public ones remain hubs for teach, training and general care. Also, while the government system covers reimbursement of most basic health care expenses, most French people buy private supplemental insurance to cover things such as private hospital beds, eyeglasses or dental work and to lower out-of-pocket expenses.
Financing
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To finance the health care system, all French employees and employers contribute to a health insurance fund. In addition, farmers and the self-employed contribute to separate funds. Out-of-pocket expenses consist solely of small co-pays, and there are no deductibles. The government, on the other hand, reimburses health care for the unemployed, in part, through income taxes. The prices of each procedure are determined by specialists. These "tarif de conventions" are then, however, negotiated by doctors' unions and the health insurance funds.The system allows specialists, such as surgeons with particular expertise, to charge more from time to time.
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Coverage
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The French program covers basic health care for everyone. Reimbursement in France varies from 70 percent for a doctor visit or X-ray, to 80 percent for minor surgery, to 95 percent for major surgery or childbirth. The system reimburses the sickest people the highest percentage. For example, diabetes or cancer treatments come completely free. If a patient needs to see a specialist, he must first register with a general practitioner.
Protection Maternelle et Infantile
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Under the Protection Maternelle et Infantile branch of the system, pregnant mothers and children receive numerous checkups from pediatricians, nurses, midwives, psychologists and social workers. In some cases, the PMI even offers a financial incentive. This program, and others like it, intends to lower costs by creating a more healthy population.
Effect on Doctors
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Doctors in France receive noticeably lower salaries than those in the United States. Yet the gap is not as large as it originally seems. For one, the state pays for medical school and, hence, physicians have no student loans to pay back. Furthermore, malpractice insurance in France is much smaller than the $55,000 U.S. doctors normally pay per year. Finally, the government covers about two-thirds of each doctor's Social Security tax, which can make up 20-40 percent of their yearly salaries.
Advantages
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One benefit of the French health plan is that each person can choose the doctors and specialists that she would like to see. Moreover, the system allows doctors to prescribe the medications and treatments they wish, something often amiss in the private U.S. care, where insurance companies often dictate prescriptions. The key benefit, however, is that everyone receives coverage and, indeed, 65 percent of French citizens say that they are satisfied with the system, according to an article in Business Week.
Problems
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Yet France continues to experience some problems with its health care system. Health care inflation rises every year and hasn't stopped despite efforts to control it, by creating reformed rules about seeing specialists, for instance. The government has had to increase the proportion of reimbursement that comes from income tax and decrease reimbursement rates of certain procedures in an attempt to restrain the growth of the deficit.
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