Health care in France: recent developments.

Abstract

Health care in France falls almost exclusively under the responsibility of the Social Security department, which covers almost all the expenditures related to health care, whether hospitalization or medication is concerned. For severe diseases or surgery the coverage is likely to reach as much as 100%. The medical expenditures for several severe diseases, such as cancer, myocardial infarction, or neurodegenerative diseases are 100% covered for a period of time as long as three months. For some procedures, full coverage may be achieved by using a subscription to private health care insurance. Access to cover by the state has recently been opened to anyone living in France, after passage of a special law. There is still a lack of intensive care and hospice beds, given the rapidly increasing number of elderly who cannot be maintained at home. There is a tendency to reduce the number of beds in private and public hospitals due to the great number of such institutions and the general concern that a low volume of procedures, associated with inexperienced health care professionals, is likely to increase morbidity and mortality as well as public health care expenditure. Patients are still free to choose doctors and hospitals (whether private or public), provided that beds are available and that specific procedures can be carried out in the vicinity. So far no waiting list is needed, except for specific procedures performed by a few specialists of high repute. Health care expenses are increasing continuously, which results in a very expensive system in France.