Abstract

The general goals of the French healthcare system are: full coverage, access without waiting lists and patient choice and satisfaction. Recent reforms have aimed to improve governance and increase transparency in the system, to contain expenditure without diminishing equity in access, and to improve geographical equity in access to care. The central government plays an important role in defining policy and has been increasingly involved in containing expenditure. Although the system was originally based on the Bismarck model of social insurance, France has moved towards a more centrally organized single-payer model. France has universal and compulsory coverage of healthcare costs for all residents. Coverage is provided by non-competitive social health insurance. Voluntary complementary insurance is available, offered mainly by not-for-profit mutual associations or provident institutions. 95 per cent of residents are covered through employers or vouchers. Private for-profit insurers offer complementary coverage for a limited list of services.