Liberty, Equality, And Healthcare In The French Healthcare System

Liberty, equality, and fraternity. The infamous expression dates back as a political motto to galvanize the citizenry in the midst of the French Revolution. Today, this phrase exemplifies not only the republican ethos that incited the revolution, but also embodies the country’s healthcare system; Liberty, defined by the freedom of a patient to choose any healthcare provider he or she wishes to. Equality, characterized in the universal medical coverage for all citizens, regardless of socioeconomic status. Fraternity, expressed by the overwhelmingly positive regard French citizens view their healthcare, with 88% describing the system as “good or very good” (Chevreul K 181). Consequently, the French healthcare system is exceptional compared to

The Statutory Health Insurance (SHI), financed primarily through “payroll taxes and...an income tax,” covers the entire resident population (E. Mossialos 59). The SHI is composed of several schemes in which “individuals and their families are affiliated with a scheme based on their employment status and remain in [that] scheme in retirement.” No individuals can opt out to ensure coverage among “virtually the entire population.” The most popular scheme “covers employees in commerce and industry,” representing approximately 88% of the population. Despite the variety of SHI schemes for variations in employment statuses, such as agricultural or self-employment, “there is no competition among the schemes.” For low-income individuals

In France, healthcare relies on the “preferred doctor” scheme, which “represents a soft form of gatekeeping.” Patients would generally obtain a diagnosis with their GP, and then are referred to specialists for further care. However, patients have the option to neglect their GP’s referrals and instead take advantage of “direct access to specialists or other GP’s” (Chevreul K 75).There are no networks of doctors and hospital, as is the case in the American healthcare system, although patients seek other providers would only face “lower levels of reimbursements” (Chevreul K 54). As a result of France’s universal healthcare system at the statutory level, patients are not restricted by the doctor and hospital networks, whereas American patients are coerced to choose a provider as dictated by their private insurance. As a result, “France is generally perceived as a country with an extensive patient choice,” bolstered by the fundamental principle that it is “a patient’s right to choose [a] health professional and hospital” (Chevreul K