Inspired by the debate over American health care reform, Milestone tapped Jeff Steiner to give an overview of the French health care system. Jeff has lived in France for the past few years and is the creator of the Americans in France website, a resource for Americans looking to live or travel in France.
“French healthcare isn’t really socialized; the French state doesn’t run everything. What you have is government insurance (Assurance Maladie) on one side that covers about 70% of any given treatment. On the other side is a mix of private/public hospitals, doctors (most of whom are in private practice), nurses (many are independent and like doctors in private practice) and private (but heavily regulated) labs and pharmacies.
The government insurance is financed through taxes. Looking at my last pay slip, about 13.5% of what I made (gross) was paid into the Assurance Maladie Fund. The accounting is to the advantage of the worker; I paid .75% of my gross income to Assurance Maladie, whereas my employer paid a 12.8% tax on my gross income.
The 70% reimbursement figure is generally the lower end of coverage; long-term illnesses, such as cancer, are covered at a rate of 100%. Many French citizens have private, top-up insurance that covers whatever the French state does not. From experience, what seems to fall below 70% are things like medication and eye glasses. But I’ve noticed that medication in France seems to be cheaper than in the US, even when you pay the full cost.
Personally, my family doesn’t have private top-up insurance (that would cover the 30% that Assurance Maladie does not), but when we looked into buying some, monthly premiums looked to be about 100-150 euros/month for a family of three (approximately $145-218 US). Coverage varied but because Assurance Maladie covers anything long-term, there aren’t any preexisting conditions. In fact, I believe an insurer only has a right to minimal health information like age and sex.
To give you an idea of some everyday health care costs in France; it costs 22€ ($32 US) to see a doctor (it’s more to see specialist), 70% is covered by Assurance Maladie. The patient cost is 6.60€ ($9.60 US). In November of last year my son had appendicitis and spent five days in the hospital. Our total bill (it was just one page) came to 98€ ($142 US).
That’s not to say that French health care is all roses. The Assurance Maladie’s general fund is in debt to the tune of billions of euros, and has been for many years. I like the health care I’ve received in France but finding the money to pay for it isn’t easy. Also some areas of the country have a shortage of doctors and nurses.”