NCPA - National Center for Policy Analysis

French Health Service on Verge of Collapse

February 12, 2004

Without fundamental reforms France's national health service, rated the best in the world by the World Health Organization, will collapse within the next 15 years. A commission investigating the future of the national health insurance system says if present trends continue, the service -- forecast to finish this year $9.83 billion in the red -- will be a staggering $62.56 billion over-budget by 2020.

Most French patients think their health service is outstanding. It provides a first-class level of care for minimal personal outlay. Patients are free to go as often as they like to as many of the country's 94,000 general practitioners or 89,000 specialists, ask for whatever treatment or medicines they like, and expect to get most of the cost reimbursed by the state.

The system is, however, very expensive:

  • France's health care budget is the world's third largest, accounting for 9.8 percent of gross domestic product (GDP) compared with 10.4 percent in Germany and 6.9 percent in Britain.
  • And the system is also unnecessarily complex and wasteful, rewarding doctors who see patients as often as possible, and encouraging them to over-prescribe.
  • Partly as a result, the French are now Europe's heaviest pill-poppers, consuming more than three times as many as their neighbors in Britain, Germany and Italy.
  • Raising the monthly contributions paid by the unemployed, and in particular by pensioners;
  • Increasing refunds given to patients who take preventative health care measures;
  • And improving the behavior and expectations of both patients and professionals by reimbursing only drugs and operations that had been proven to be effective.

National insurance, the report says, can no longer be a simple payment mechanism for health care service.

Source: Jon Henley, "French health service on verge of collapse, says commission," Manchester Guardian, January 24, 2004.

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