Handout 13: Health Care and Social Care
Check topics on :"Discovering France" on
1945 : Creation of Sécurité Sociale and
Nationalizations under de Gaulle.
Health is a major concern of the French: in 1998,
they spent 110.6
billion euros on medical care and goods. 75% of this
was covered by
the social security system, with an increasing proportion
being met by
households and insurance companies.
The SECU: Universal social
protection, regardless of income, is a comprehensive system called Sécurité
Health Insurance (which
covers risks relating to illness,maternity, disability and death)
I. HEALTH CARE-Health
for all CMU ( universal sickness coverage/Couverture
maladie universelle )
also provides concrete assistance for raising children
age: medical procedures and retirement,
through an old age pension fund :obligatory
retirement system (49% of the payment). The contribution period is 37.5
years on average.
benefits represent 9% of the spendings made by the Sécurité
France has one of the most effective
welfare systems in the world.
-one of the highest in the European
Union, comparable to that of Denmark, Finland, Austria and the Netherlands.
Benefits break down as follows: pensions (49.2%), health (27.2%),
family allowances (12.8%) and employment aid (unemployment benefit,
vocational training and social integration) (8.4%).
- free supplementary cover. Eligibility
for supplementary cover is means-tested (EUR 533.57 per month for a single
person). people are also eligible for dental treatment and prescriptions
for glasses which they previously tended to do without.
smart card, the Sésame
record card (see wiki and http://www.gemalto.com/brochures/download/france_health.pdf)
issued to all French and foreign contributors to the
French national insurance scheme, on which doctors record important medical
information, such as tests, consultations, prescribed treatments, etc..
Private practice plays an important
and the patient is free to choose his or her health-care provider.
France's health policy is designed
to ensure equal access to health care for the entire population.
Although some disparities remain as a result of differences in living standards,
education or place of residence, these are much less marked than for many
other items of household expenditure.
The public authorities are also endeavouring
to develop preventive medicine, organizing large-scale public-health
campaigns on major health risks. France's infant mortality rate is amongst
the lowest in the world and its life expectancy is amongst the highest,
increasing by approximately 100 days every year.
medecine (homeopathy/ acupuncture/ water treatments at spas
etc.) is prescribed, recognized and reinbursed by the Health Scheme.
Since 1998, health care has no longer
been funded only by national insurance deducted from the salaries of employees,
but by a tax,
the CSG (generalised social contribution),
levied on all gross earned and unearned income.
DEFICIT: French Social Security system which reached 2.3
billion d'euros in 1998. By 1999, this had fallen to 0,60 billion d'euros
thanks in particular to the introduction of a temporary extra levy
SOCIAL CARE: State= role
& responsability= Protection and Provider of Jobs/Law...
This commitment transcends political
While there is undoubtedly
more support for public service on the left than on the right, in the last
ten years we have seen all governments, whether right-wing or left-wing,
taking very similar public positions on this subject, particularly
in European debates.
The commune is the lowest tier of France's
The préfet (Governor of a region)
is a high-ranking civil servant who represents the State at the level of
the department or region. Besides a range of important administrative duties,
the role of the préfet is to ensure that central government decisions
are carried out properly at local level.
Broader central government role.
Services ; in the public interest, which, one way or another, are
carried out by the authorities.
The courts, the police, education,
disease prevention and health promotion are all public services , rail
transport and the supply of electricity.
Long term unemployment and
RMI (reinsertion revenue, minimum allowance)
Defence: French Army (voluntary)/ the French Legion: Peace keeping.
order to conserve and develop France's natural heritage, the government
has established six national parks, 128 nature reserves,430 designated
areas for protected species and 299 protected coastal areas. France also
has 29 regional nature parks covering more than 7% of the country.22.11
billion euros are allocated to the protection of the environment -
378.07 euros per inhabitant. Three quarters of this goes on waste water
management and waste disposal.
Since the Rio and Kyoto meetings and the World Summits on the Environment and Global Sustainable Development,
France and the European
Union have taken collective initiatives in view of protecting the environment.
These have materialized in
laws which demand that governments down to the local level draw up
and implement actions and projects in line with the laws.(e.g. recycling/
clean air, clean water acts etc.).France
a key player in this movement. They created ECO-labels
products respecting the environment in their fabrication processes.
SECU: Social Security
insertion wage (welfare for those who do not qualify for unemployment benefit)
SMIC: Minimum wage )
CSG: Generalized social contribution from a tax levied on all gross
earned and unearned income.
1. What does the SECU cover?
2. Outline the French health care system called CMU. Are patients restricted to a list of doctors?
3. If the patient wants
acupuncture, is it covered by their health care?
4. What are the advantages of this health care system?
Do you see some problems ?
5. How is this health care funded?
6. What is the Sésame Vitale
7. What are SMIC?
8. Are health care and pension plans for everyone?
9. What are the respective strengths and weaknesses
or the French and USA medical and social care ?
10.What main differences seem to exist between the
ways of the US and of the French in terms of general attitudes to public services
, what are the constraints
and the freedoms?
View documentary:Interview with a doctor-and film Sicko (M
(1) Sicko (M Moore) American
maverick compares US healthcare with others (France, English, Cuba...)
(2) Romuald et Juliette (Mama there is a man in
Social satire. 1. the portrayal of
the "haves" and "have nots in France. 2. their values, housing and preoccupations
3. their interactions within the families 4. attitudes towards
school 5. love and marriage 6. References
to the health care system or the social services 7. References
to social prejudices.
Copyright 2008, T.Saint Paul