France

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Health systems in transition
France
Efforts to contain premium costs have focused on increased transparency
to facilitate comparisons of the scope and depth of coverage. The 2012 Social
Security Finance Act required VHI firms to report the amount and composition
of their administrative costs as a percentage of premiums as of 2014.
3.5.4 Public policy
To address the economic barriers faced by poorer people in accessing
complementary coverage, particularly those just over the CMU income ceiling,
the ACS voucher scheme was created in 2004. Financial assistance in the form
of a “health check” (cheque santé) is offered to people whose incomes fall
below a defined ceiling (135% of the CMU-C ceiling as of January 2012) for
the purchase of VHI. The amount offered depends on the age of the individuals
in the household, ranging from €100 per year for individuals under age 16 to
€550 for those over age 60, and may not exceed the contract amount. However,
fewer than half of those eligible participate in this scheme (CMU, 2012). Recent
reforms include selection of a limited range of contracts to facilitate choice and
to ensure the quality of the offers.
To increase the population covered by group contracts, employers providing
such contracts to their employees receive fiscal rebates, while employees
may deduct the premium cost from taxable income. Under the National
Interprofessional Agreement (l’accord national interprofessionnel) signed by
representatives of employers and employees in 2013, all employers regardless
of size will be required to offer group VHI contracts to their employees by 2016.
3.6 Other financing
Most additional sources of financing relate to health and social care sector
services for elderly and disabled persons, including individuals with long-term
mental illnesses.
Financing long-term care for the elderly
Following the heat-wave crisis in the summer of 2003, the CNSA was created
to improve provision and funding of long-term care services, such as SSIAD
and nursing homes.
There are currently three sources of funding for long-term health and social
care for the frail elderly in France: