HSPM
Health Systems and Policy Monitor
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France
Health systems in transition
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Country overview
France runs a statutory health insurance (SHI) system providing universal coverage for its residents. The system is financed through employee and employer contributions, and increasingly by earmarked taxes on a broad range of revenues. France has three main SHI schemes (i.e. the general scheme, the self-employed professionals’ scheme, and the agricultural scheme), as well as a variety of other small special schemes. All SHI schemes provide the same coverage and benefit policies. Funds are pooled at the national level with the possibility of subsidies between schemes.
The main players in the French health system are the SHI funds and the national government. Despite several organizational changes that have devolved power to regional health agencies, the central government has retained substantial control over the governance of the health system. Recently, France has moved in a new direction towards prevention, health promotion, and patient empowerment, which breaks from the previous system that focused on curative care.
France has a generous benefits basket and low OOP payments. However, SHI does not cover some goods for financial reasons including, for example, dental and optical devices, even though efforts are ongoing to expand coverage. SHI finances a large share of total health expenditure, but voluntary, complementary private health insurance (VHI) also plays a large role. Over 95% of the population has VHI and almost 20% of the population benefits from a state-funded VHI, which allows full coverage of all services and medicines included in the benefits basket.
PACE
Progress Addressing Cancer in Europe
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