With a population of approximately 67 million, France has a Universal Health System, where health insurance is mandatory for the entire population, and just like in Brazil, there is a card to use in the system, which is largely financed by the state, through a national insurance system.
France has as its organizing principles the following items:
- Coexistence of the public service provision side with the private, with or without profit;
- Free choice of health professionals and establishments;
- Autonomy for the installation of offices;
- Direct payment, by users, to health professionals and services, with partial reimbursement of expenses;
- Freedom of prescription;
- Professional confidence.
According to the World Health Organization (WHO), France is the leading country in improving health care in general, and it is in first place among the ten best health systems in the world, along with Italy, San Marino, Andorra, Malta, Singapore, Spain, Oman, Austria, and Japan.
Such classification is due to investments made in favor of the country's health. In 2014, the French government spent 15.69% of GDP on health and paid 78.21% of spending in the area.
French health insurance
The inhabitants' care is provided by public hospitals, private non-profit hospitals (linked to foundations, religious organizations, and other associations), and commercial hospitals, in addition to a large sector of outpatient care composed of independent professionals, such as general practitioners and specialists.
Almost 62% of France's hospital capacity is either owned or managed by the government. The remaining capacity is divided equally between non-profit sectors and profitable institutions. Besides, the country has a system of co-participation in health expenditures, that is, after the patient pays the health professional or the drugs, he is reimbursed by the State.
The reimbursement made to the patient depends on the service provided, but it is usually 80% and, in cases of diseases with a long duration of treatment or high costs, it is 100%. Reimbursement can be completed if the patient regularly pays for additional health insurance, which is a recurring case, with 96% of the population adhering to such practice.
According to the recently established laws, general practitioners are expected to act as "gatekeepers", who are responsible for referring the patient to a specialist or hospital when necessary.
In this case, the patient will be able to choose between going directly to the general practitioner (option encouraged by the system) or going directly to the specialist, however, this second option would result in less reimbursement, except for:
- Emergency characterized situations;
- Gynecological care;
- Pediatric, psychiatric and ophthalmological consultations.
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Public health vs Private health
As seen earlier, the health system in France is Universal, and much of it is financed by the State. To have access to the public health system, it is necessary to make the Carte Vitale, which is the French social security card. Carte Vitale gives citizens the right to take advantage of medical services, hospitals, and dentists, perform examinations and buy medicines.
The private insurance used for the reimbursement of amounts spent on health care by the citizen is called Mutuelle, and the reimbursement amounts are deposited with Carte Vitale, which will be linked to a citizen's current account.
Unlike social security, Mutuelle is not mandatory, however, it is highly recommended. Also, for a citizen to be able to hire a Mutuelle, he must be already registered with social security. It works as a health plan, and the price of each one varies according to age, occupation, and the services that are reimbursed.
Tests and medications
Regarding the exams, there is total coverage by the government, in which case, it is not necessary to pay in advance to receive reimbursement, the patient only needs to present the health insurance cards at the entrance window before making them.
When it comes to medicines, the government also makes them available free of charge, just by taking them out at a pharmacy. For this, it is necessary to present the Carte Vitale, however, not all medicines are free, so one part is covered by public insurance and the other is paid by Mutuelle.
In hospitalizations, the patient also does not need to make any payments, which is the responsibility of his health insurance, whether public or private. The process works as follows: after the consultation or procedure, the hospital sends the bill through the post office, and the patient is asked for insurance data, and the patient, in turn, must send such information by mail as well, so that the account is settled by the insurance.
Source: Euro Dicas