Overview

The French health system combines a social health insurance system with a national health system approach. It provides universal pop­ulation coverage and a generous benefits package.

The Ministry of Health (MoH) undertakes the main stewardship role and has substantial control over the health system, although at the regional level, regional health authorities have public health and health care planning and financing responsibilities within their remit.

Current health expenditure per capita in France (US$ PPP 6330) in 2021 exceeded the EU average and public expenditure on health was 85% of total health expenditure in 2021. Cost sharing is required for all essential services, so the majority of the population take out private complementary insurance to reduce out-of-pocket payments.

Out-of-pocket  costs have been stable at approximately 9.0% of health expenditure in both 2021 and 2022. The majority of OOP spending was on long-term care, followed by pharmaceuticals and therapeutic devices, and outpatient care.

Recent reforms in France have focused on four main areas: improving financial access to care to avoid forgone care; improving physical access to care, particularly in under­served areas; strengthening prevention; and reforming payment methods for providers, particularly in the hospital sector. Persisting challenges include ensuring the sustainability of the health workforce, particularly to secure adequate numbers of health professionals in medically underserved areas (rural and less affluent com­munities), and improving working conditions, remu­neration and career prospects, especially for nurses, to support retention.