France

8. Conclusions
8. Conclusions
In France, the overall health status of the population is good as well as the
degree of financial protection provided by the health system. Women live
longer and older people remain in better health than in many European
countries. Patients in France are three times less likely to report forgoing
care because of long waits than the EU average. Public financing of health
care expenditure is among the highest in Europe and OOP spending one of
the lowest.
Nonetheless, major problems include social and geographical inequalities
in health status and access to care; a relative underdevelopment of preventive
care compared with acute care; and a lack of coordination between the hospital
sector, the ambulatory care sectors and the health and social care sectors, in
particular in caring for patients with chronic diseases but also in developing
preventive care and intersectoral policies.
Social inequalities remain in terms of health status and access to care.
Life expectancy at age 35 is seven years lower for working class men and
three years lower for working class women compared with managers. These
social health inequalities result not only from risk factors such as alcohol and
tobacco consumption but also from differences in access to health care, which
have increased over time. Indeed income-related inequalities in health care
utilization remain despite universal coverage and relatively low OOP payments.
This inequity in access is predominant in goods and services for which patients’
OOP expenditure is the highest, such as dental care and consultations with
specialists engaging in extra-billing. Geographical disparities in the density of
health professionals also affect access to care in some areas of France. While
the average physician density should provide adequate nationwide coverage,
certain areas are underserved.