Abstract

At a time when the French healthcare system was going through its most serious crisis, in terms of both organisation and funding, the board of governors of the National Academy of Medicine decided, at its meeting of May 26, 2003, to set up a workgroup on the future of the health insurance system. The workgroup revisited the concept of health insurance, taking economic constraints into account. Medical care covered by the national health insurance system is considered as "'free" by both national insurance contributors (patients) and doctors, who are the primary "spenders". The Academy was the first organization to examine the reasons for the budget deficit, which is largely due to State with nothings. In 2008, the Academy created a healthcare insurance committee. Deficits piled up, amplifying the debt, which eventually may spiral out of control. The French population finally became concerned at the situation. In 2010, France's social security budget deficit will reach some 30.5 billion euros, including 14.5 billion for healthcare insurance alone, a figure which is increasing by 5 billion euros each year. The French President recently announced the creation of a workgroup to examine healthcare expenditure. The Academy's healthcare insurance committee is convinced that reform is necessary and feasible, while preserving the underlying principles of our present system, namely humanism, freedom of choice, responsibility and solidarity.

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