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xxvi Health systems in transition France level, such as providing infrastructure, reducing start-up costs and enabling holiday cover. In addition, new methods of health care organization through task transfer and the use of information technologies such as tele-health have been encouraged since 2010. The increasing demand for long-term care remains a major concern in the government’s plan. However, despite strong government support, public coverage of long-term care for the elderly to achieve greater equity in access remains one of the main challenges of the system. Assessment of the health care system The French health care system has long enjoyed the reputation of being one of the best in the world, combining universal health coverage (Couverture Maladie Universelle; CMU) with a generous supply of health services. This reputation comes in large part from success in meeting its goals of full coverage, access without waiting lists, patient choice and satisfaction. The combination of a basic universal public health insurance system and voluntary complementary private insurance (which provides reimbursement for co-payments required by the public system as well as coverage for medical goods and services that are poorly covered by the public system) results in low OOP costs and high medical care utilization. France’s average life expectancy of over 80 years is in part testament to the strong combination of good health care and good public health policies in France. Despite these positives, there are also some shortcomings, especially when considering efficiency and socioeconomic inequalities in health outcomes and inequities in access to health care. Major problems include lack of coordination between the hospital sector, the ambulatory care sector and the health and social care sector, in particular in caring for patients with chronic diseases. France has also been slow in developing preventive care and intersectoral policies. However, major efforts have been undertaken in the last five years to address these issues. France is among the OECD countries for which public financing of health care expenditure is the highest and OOP spending is the lowest. The high level of health expenditure has become increasingly significant at a time when the public system is facing chronic deficits, and improving allocative and technical efficiency is a major concern in order to ensure the financial viability of the system. Measures implemented since 2010 have been particularly effective in
Health systems in transition France xxvii achieving SHI cost-containment and financing fairness, as reflected by the fact that the ONDAM has not been exceeded since 2010 while maintaining stability in the percentage of OOP expenditure over the same period.
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Page 5 and 6: Contents Contents Preface
Page 7 and 8: Preface Preface The Health Systems
Page 9 and 10: Acknowledgements Acknowledgements T
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Page 19: Abstract Abstract This analysis of
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Page 31 and 32: 1. Introduction 1. Introduction The
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3. Financing 3. Financing Health ca
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4. Physical and human resources 4.
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6. Principal health care reforms 6.
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7. Assessment of the health system
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8. Conclusions 8. Conclusions In Fr
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