France

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Health systems in transition
France
(e.g. unemployment and sick leave allowances) (3.95 percentage points for SHI).
The rate decreases to 3.8% of earned income for individuals with low incomes
who were otherwise exempt from income taxation, which represent nearly
half of French households. Moreover, because the revenue base of SHI has
been broadened and partly disconnected from earnings, it is less vulnerable to
wage and employment fluctuations. A share of CSG contributions is generally
deductible from income tax. In 2012, 70% of the revenues from the CSG went
to the SHI schemes, accounting for 35% of their financing.
The pharmaceutical industry is also required to contribute through a 1.6%
tax on their turnover, a tax on advertising, a tax on drug retailing and an
additional tax if their turnover exceeds a limit set in the Social Security Finance
Act. In 2012, these taxes raised €1.04 billion for SHI. Additional revenue for
SHI is levied on the profits of companies with turnover of more than €760 000.
This 0.13% tax is estimated to have levied €55 million in 2013. Other taxes are
levied on polluting activities of companies. In 2012, employers’ contributions,
employee’s contributions and CSG revenue accounted for 82.3% of total SHI
revenue. The remainder was provided mainly through state subsidies and
additional earmarked taxes (e.g. on tobacco and alcohol consumption).
Main body responsible for collecting SHI funds
The Union for the Recovery of Social Security Contributions and Family
Allowances (Union de Recouvrement des cotisations de Sécurité Sociale et
d’Allocations Familiales) is in charge of collecting contributions and CSG at
the local level. The money levied flows into a single national pool managed
by the Central Social Security Agency (Agence centrale des organismes de
sécurité sociale) and is distributed among the different national branches (SHI,
retirement fund, family allowance, etc.) on the basis of contribution rates
defined by law.
Main body responsible for solving the social security debt
Since 1996, the contribution for solving social security debt, the social debt
repayment contribution (contribution pour le remboursement de la dette
sociale) was implemented to address the increasing deficit of the social security
system. The contribution is 0.5% of revenue regardless of the source (earned
income, benefits, capital, sale of assets, etc.). At the same time, a special fund
was created to manage the social security debt, the Agency for Funding Social
Security Debt (Caisse d’amortissement de la dette sociale). To ensure that the
social security debt is not continuously transferred to the next generation, the