Healthcare in France

As promised in last Sunday’s post, today’s subject is health care à la française, in which I will talk about how much my family pays for health care, and what we are entitled to. The story of my first encounter with the French system (the Sécu or Securité Sociale) is here.

I earn €1340, before les charges, or payroll deductions, are taken out- about €1040 take home. (Taxes are not deducted from your salary in France; you pay them separately.) I pay .75% of my gross salary or €10.05 and my employer pays 12.8% or €171.52 for the health care, maternity leave and disability charges.

My husband earns €2500 before payroll deductions are taken out, €1921 take home. He pays .85% of his gross salary or €21.25. His employer pays 12.8% or €320.00 for the health care, maternity leave and disability charges. I assume that he is responsible for a higher percentage than I am because of his higher salary.

In addition to the contributions to the Sécu, he also pays for our supplementary coverage (or mutuelle). His employer requires him to be covered through their plan, meaning that even if it was also obligatory through my employer, at the very least, my husband would need to go through his employer’s plan. Fortunately, at least for us, my employer doesn’t provide supplementary coverage, so we’re happy that his employer does. For this supplementary insurance he pays 1.38% or €38.27 and his employer pays the same amount.

Generally what is covered by the Sécu breaks down like this: most things (doctor’s visits, specialists, hospital stays, medicine, therapies) are covered and reimbursed between 60% and 80%. For example, when I go to the family doctor I pay €22, about a month later I am reimbursed 70% by the Sécu. A month or two after that, I am reimbursed by our mutuelle for the remaining 30%. Our children pay €27 per visit to the same doctor, as family doctors are allowed to apply a special pediatric rate. For my daughter’s recent birth, for which I had some complications and almost daily monitoring which required frequent hospital visits, I paid nothing out of pocket.

The mutuelle costs €76.54 per month to cover our family of five. This is somewhat low for a mutuelle; for a certain period we were covered by my mother-in-law’s insurance plan and paid around €200 per month for two adults and two children. It covers the difference in our out of pocket costs from what the Sécu reimburses. It also pays extra for things like glasses and braces. Some astounding costs: laser eye surgery (per eye) would cost us €122. In vitro fertilization would cost €305. They pay €763 towards funeral costs, and when a baby is born, they give you €153.

In general I am really happy with what we have here. I believe that the US system is in desperate need of change and I hope that the new president, whomever he or she may be, will have the courage and support necessary to affect such change.

To those reading this post who live outside of the United States, what is your health insurance like? How much do you pay, and what are you entitled to?
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This is an article from a website for expats, Expatica, and does an excellent job of explaining the French system. It was published in 2004.

This is a 2007 article from Business Week, subtitled ‘The nation’s system isn’t quite as superb as Sicko maintains, but it’s pretty good’. It says “to grasp how the French system works, think about Medicare for the elderly in the U.S., then expand that to encompass the entire population.” I remember the same point being made during the presidential debates in season 7 of my favorite show ever, The West Wing.

Here is another article from 2007, from The Boston Globe, in which the author says “…the French share Americans’ distaste for restrictions on patient choice and they insist on autonomous private practitioners… (t)heir freedoms of diagnosis and therapy are protected in ways that would make their managed-care-controlled US counterparts envious.”

From the Embassy of France in the United States comes this overview.