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Capital punishment, race, and rape in mid-twentieth-century Florida [Full text will be published on January ]. An Awful and Impressive Spectacle: Aline Helg, Plus jamais esclaves! Follow us RSS feed. Instead, the government has taken responsibility for the financial and operational management of health insurance by setting premium levels related to income and determining the prices of goods and services refunded.
Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers. Until , coverage was restricted to those who contributed to social security generally, workers or retirees , excluding some poor segments of the population; the government of Lionel Jospin put into place universal health coverage and extended the coverage to all those legally resident in France. There are public hospitals, non-profit independent hospitals which are linked to the public system , as well as private for-profit hospitals. France — followed well behind Bismarckian Germany, as well as Great Britain, in developing the welfare state including public health.
Tuberculosis was the most dreaded disease of the day, especially striking young people in their 20s.
Health care in France
Germany set up vigorous measures of public hygiene and public sanatoria, but France let private physicians handle the problem, which left it with a much higher death rate. However the reformers met opposition from bureaucrats, politicians, and physicians. Because it was so threatening to so many interests, the proposal was debated and postponed for 20 years before becoming law in Success finally came when the government realized that contagious diseases had a national security impact in weakening military recruits, and keeping the population growth rate well below Germany's.
The current system has undergone several changes since its foundation in , though the basis of the system remains state planned and operated. According to various experts, [ who? To control expenses, these experts [ who? The entire population must pay compulsory health insurance. The insurers are non-profit agencies that annually participate in negotiations with the state regarding the overall funding of health care in France. A premium is deducted from all employees' pay automatically. The Social Security Funding Act, set the rates for health insurance covering the statutory health care plan at 5.
After paying the doctor's or dentist's fee, a proportion is reimbursed. Most of them are managed by non-for-profit groups. Under recent rules the coordinated consultation procedure, in French: However the system offers free choice of the reference doctor, which is not restricted to only general practitioner and may still be a specialist or a doctor in a public or private hospital.
The goal is to limit the number of consultations for the same illness. As costs are borne by the patient and then reimbursed most of the time on the spot as all doctors and drugstores can read the " Carte Vitale ", a smart card with all information on the patient and the co-insurance company , patients have freedom of choice of where to receive health care services. Minister of Health and Solidarity is a cabinet position in the government of France.
The healthcare portfolio oversees the public services and the health insurance part of Social Security. As ministerial departments are not fixed and depend on the Prime Minister's choice, the Minister sometimes has other portfolios among Work, Pensions, Family, the Elderly, Handicapped people and Women's Rights. In that case, they are assisted by junior Ministers who focus on specific parts of the portfolio.
People can subscribe to a "mutuelle" non profit insurance or a private for-profit insurance for additional cover. In large cities, such as Paris, the physicians especially specialists charge significantly more for consultations i. For instance, for an ophthalmologist in Paris, if the patient pays 80 EUR, he will be reimbursed 5. This implies prevention, education, care of diseases and traumas that do not require a specialist.
They also follow severe diseases day-to-day between acute crises that may require a specialist.
This policy has been applied to unclog overconsultations of specialists for non severe reasons. They survey epidemics , fulfil a legal role consultation of traumas that can bring compensation, certificates for the practice of a sport, death certificates, certificates for hospitalization without consent in case of mental incapacity , and a role in emergency care they can be called by the SAMU , the emergency medical service. They often go to a patient's home if the patient cannot come to the consulting room especially in case of children or old people and they must also perform night and week-end duty.
Because the model of finance in the French health care system is based on a social insurance model, contributions to the program are based on income. Prior to reform of the system in , contributions were The reforms extended the system so that the more wealthy with capital income and not just those with income from employment also had to contribute; since then the 6. In its place a wider levy based on total income has been introduced, gambling taxes are now redirected towards health care and recipients of social benefits also must contribute. The founders of the French social security system were largely inspired by the Beveridge Report in the United Kingdom and aimed to create a single system guaranteeing uniform rights for all.
However, there was much opposition from certain socio-professional groups who already benefited from the previous insurance coverage that had more favourable terms. These people were allowed to keep their own systems. One for commerce and industry workers and their families, another for agricultural workers and lastly the national insurance fund for self-employed non-agricultural workers. All working people are required to pay a portion of their income into a health insurance fund, which mutualizes the risk of illness and which reimburses medical expenses at varying rates.
Health care in France - Wikipedia
Children and spouses of insured individuals are eligible for benefits, as well. Each fund is free to manage its own budget and reimburse medical expenses at the rate it saw fit. Today, this system is more or less intact. All citizens and legal foreign residents of France are covered by one of these mandatory programs, which continue to be funded by worker participation. However, since , a number of major changes have been introduced.
Firstly, the different health care funds there are five: Secondly, since , the government now provides health care to those who are not covered by a mandatory regime those who have never worked and who are not students, meaning the very rich or the very poor. This regime, unlike the worker-financed ones, is financed via general taxation and reimburses at a higher rate than the profession-based system for those who cannot afford to make up the difference. Such declaration is not required for children below 16 years old because they already benefit from another protection program , for foreigners without residence in France who will get benefits depending on existing international agreements between their own national health care program and the French Social Security , or those benefiting from a health care system of French overseas territories, and for those people that benefit from the minimum medical assistance.
An important element of the French insurance system is solidarity: Finally, for fees that the mandatory system does not cover, there is a large range of private complementary insurance plans available. The market for these programs is very competitive. Such insurance is often subsidised by the employer, which means that premiums are usually modest.
There are recommendations on clinical practice RPC , relating to the diagnosis, treatment and supervision of certain conditions, and in some cases, to the evaluation of reimbursement arrangements. ANAES also published practice guidelines which are recommendations on good practice that doctors are required to follow according to the terms of agreements signed between their professional representatives and the health insurance funds. There are also recommendations regarding drug prescriptions, and to a lesser extent, the prescription or provision of medical examination. By law, doctors must maintain their professional knowledge with ongoing professional education.
Ambulatory care includes care by general practitioners who are largely self-employed and mostly work alone, although about a third of all GPs work in a group practice.