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National markets insights: France



France Healthcare System & Market


Health care in France is characterised by a national programme of social health insurance (NHI), managed almost entirely by the state and publicly financed through employee and employer payroll contributions and earmarked taxes. For the majority of patients, medical goods and services are not free at the point of use. However, universal access is guaranteed by schemes for those on low incomes and/or chronic conditions. Although NHI covers a reasonable proportion of a patient’s health care costs, it does not cover them all. For this reason, the compulsory government scheme is accompanied by a prominent voluntary private health insurance (VHI) sector, which covers most out-of-pocket payments and areas that are under-insured by NHI. 


Approximately 90 per cent of the population are enrolled in a private plan – a number that has grown steadily over the years – and for this reason the VHI sector is increasingly making up for shortages in NHI funding through taxes on its growing income. This is in exchange for greater involvement in the management of health care provision. Although the management and financing of health care comes from predominantly public sources, the provision of health care is more mixed: providers of outpatient care are largely private, whilst the majority (approximately three-quarters) of hospital beds are provided by public or not-for-profit hospitals.

Faced with increasing health care costs, the government has introduced a number of reforms in the past two decades that have tried to control NHI expense and improve efficiency and quality, whilst also decreasing health disparities between regions and socio-economic groups. Although there are many areas still in need of improvement, it is worth exploring the French health care system for the innovations they have made in using the private health insurance market to supplement public funding of health care and the principles of cost-consciousness that they encourage through user-fees.


Download CIVITAS report on French market

Download the Malsamamind presentation of French eHealth & Silver Economy market


French Electronic Health Record_case study IHE


Health IT interoperability guidelines ASIP Santé (french)


French ECHAlliance Ecosystems



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