France: well being system assessment 2023

The French well being system is structurally based mostly on a social medical insurance method, nevertheless it additionally shares Nationwide Well being System objectives mirrored within the single public payer mannequin, the significance of tax-based income for financing healthcare, robust state intervention and residency-based advantages. The Statutory Well being Insurance coverage at present covers nearly 100% of the resident inhabitants underneath varied schemes, however cost-sharing is required for all important companies. Protection can be out there to undocumented migrants underneath sure circumstances.

The sustainability of the well being workforce stays a problem in underserved areas

Whereas the variety of most well being staff has elevated prior to now decade, the variety of normal practitioners per capita in France has decreased, and this development is predicted to proceed within the subsequent years. Continued challenges in France embody making certain the sustainability of the well being workforce, significantly to safe sufficient numbers of well being professionals in medically underserved areas, reminiscent of rural and fewer prosperous communities, and bettering working circumstances, remuneration and profession prospects, particularly for nurses, to help retention. Nonetheless, this can be a gradual course of and progress has been incremental.

Income-based financing has been broadened to enhance the monetary sustainability of the well being system

The nationwide authorities has been taking part in an more and more essential function in managing well being expenditure since 2010 by means of the introduction of spending targets and monitoring mechanisms for medical insurance, decreasing the preliminary independence of the Statutory Well being Insurance coverage in managing well being expenditure. To make sure monetary sustainability, sources of well being funding have been prolonged past payroll contributions prior to now a long time to incorporate a broader vary of sources of earnings, together with monetary property and investments with a spread of earmarked and value-added taxes.

Reforms are concentrating on larger coordination and integration of care, and there’s additionally a concentrate on bettering fairness and effectivity of the well being system

As with many different well being methods in Europe, the Covid-19 pandemic has dropped at mild some structural weaknesses inside the French well being system, nevertheless it has additionally supplied alternatives for bettering its sustainability. There was a notable shift within the will to offer extra room to decision-making on the native degree involving healthcare professionals and to search out new methods of funding healthcare suppliers to encourage care coordination and integration. Future reforms goal bettering entry to care and prevention in addition to persevering with the reform of major care and supplier cost to enhance the fairness in entry and effectivity. Future challenges for the well being system additionally embody bettering information availability for high quality monitoring and common analysis of well being system efficiency.