Is it true that France has Free health care/college tuition and childcare?

Question

Anyone living in France speak to me about the pros and cons?

Answer 1

First of all I just wanted to translate Mayali's answer for anyone who doesn't speak French well enough to read it.

"In France, health care is not in fact completely free. A visit to the doctor costs 21 euros, and the social security reimburses 20 euros, so 1 euro comes from your own pocket. Also, if we want to go to a specialist, we need to go and see our own GP first or we won't be reimbursed.

Education is free from nursery school/kindergarten until high school, but only in public schools. Childcare is not free."

For my own answer, the main point about healthcare in France is that it is not free at the point of delivery, except for some emergency treatment (ie A&E / ER). However the state social security system reimburses most basic health-care, and most people have complementary health insurance either through their employer or privately which will usually reimburse the remainder of common health costs. This does of course mean that to some extent France has an access to healthcare problem, since very poor people can't afford to wait for the costs to be reimbursed and therefore can't see a doctor. Note, incidentally that seeing your GP to get a referral to a specialist is also reimbursed - it's just an extra step the government introduced last year to cut down on people going to see specialists when they didn't really need to (hypochondria is pandemic in France ;-) )

Childcare isn't free, but you do get a tax rebate for whatever you spend on it, which makes it considerably cheaper.

Answer 2

I haven't lived in France nor visited it.  However, when their President was here a few weeks ago, newscasters commented on this very fact.  But I believe they want to move away from Socialism and be more of a Democracy. (yeah, we all know how THAT works !)

Answer 3

I am French so it will be difficult to me to speak you in english.

But I can do it in French.(sorry for my bad english)

En France les soins ne sont pas complètement gratuit en fait nous devons la visite coûte 21 euros et la sécurité social nous rembourse 20 euros soit 1 euro venant de notre poche pour les consultations. De plus si nous voulons aller chez des spécialistes nous devons aller chez notre médecins traitant avant si nous voulons être remboursé.

En ce qui concerne la scolarité elle est gratuite de la maternelle au lycée (Hight school) mais uniquement dans les établissement publics. La garde des enfants est quant à elle payante.

Answer 4

Go and take a look at Sicko (Mike Moore's  film).

Now to answer your question: almost free health care (you have to pay a couple of euros per doctors visit for example) and college tuition (about $200 a year). Childcare is more of a problem. If you can get a place, the amount you pay depends on your earnings.

School starts at age 3, so after the first three years you get free childcare in school time/term.

The French believe in helping each other, pooling together, rather than the Me Me Me attitude prevalent in some other countries.

Answer 5

Magic isn't it?

Well, not really... Here is the other side of the story:

free health care, education... nothing is free, it comes at a cost. What most people see is how much it cost them.

For the health service, people pay about 20% of their gross income. Let's say Mr. Frenchman earns €24000/year. He works in a camembert factory in Normandy. His employer pays €40000/year for him. Why? Well, €24000 for Mr Frenchman and the rest on taxes such as compulsory retirement scheme, health, benefits and so on...

The boss and owner of the factory Mr Cheese is paying almost 50% of his company earnings on taxes. He's dead upset because he,s got to sell his camembert €1 to realise a margin, while at the same time, Mr Brown in Sommerset also produces a camembert, but the cost is kept low and he sells his cheese €0.80.

Mr Cheese can only afford to employ 15 people, it costs him an arm and a leg!

In the meantime, Mr Frenchman (who works 35h/week) plans to go on strike to save his pension scheme (but actually civil servants are very well known for going on strike). The cost of strike will cause the closure of the Camembert factory.

While Mr Frenchman will enjoy state benefits, free health and a bursary for his kids to go to High School  his former boss is not entitled even a penny....

That's a long story, but I hope it helped you understanding the downside of it.

It is also the reason why so many businessmen in France move away (there is a lot of french companies in southern England...)

Answer 6

No, it is not precisely true but close enough.

There is a universal health insurance program which reimburses patients after they have paid the doctor or other health care provider. Although, in the final analysis, this is an expensive program (costing taxpayers about 20% of thier gross income) it works pretty well and certainly better than the National Health Service model used in the UK.

College tuition at public universities (which are the great majority of colleges) is very low (500 euros more or less) and stipends from the government are available to students who cannot afford this sum. In addition students have a wide variety of benefits available including special rates on public transport and a system of cheap student restaurants and other services ( http://www.crous-paris.fr/ ). The problem is that French colleges are pretty dreary places compared to most American colleges.  With the exception of the Grands Ecoles (which are public but operate on a different system of admissions) the average French college is more like a community college in Omaha than Harvard or the Univeristy of Michigan.

There is a system of government run Ecoles maternelle in which children may be enrolled from age 2 and which, in the early years, amount to childcare centers.

EDIT: Let me point out another fact about the French Health care system. Although I don't have the numbers at hand (I'll do some checking later to find them for you) the fact is that the overall cost of health care in France is lower than in the USA. Americans spend about 1/9 of the entire GDP on health care. No matter who is paying for it (government or the individual) everything about the American system encourages overspecialization, overcharging, overutilization, and increased costs. The overall effect on the American economy is clearly negative.

Moreover, because health care costs are largely borne by employer/employee paid private insurance, costs are maldistributed with an incentive to companies to downgrade employee health care (i.e Walmart is doing very well, in part, because they keep costs down by s******g over their workers on health care).

The inequities of the American system have reached crisis proportions and damage both the health of the American people AND our international competitiveness.

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Answer 7

I wanted to respond - I am an American living in Paris . I read all the responses and they are on the mark. Concerning health care, I just wanted to add that my husband had cancer last year and I found the handling of the bills to be more simplified than if we were living in the US. Not to mention cheaper, for the same protocol, which I checked with doctor friends living in the states.  He was not in a public hospital, which would have meant free service. The clinic cost an additional 33% more.   However, all I had to do was make  one call to my mutual insurance plan & they simply said to fax the invoice. That's it. Because he has had cancer , all his medical bills & prescriptions are paid by the state 100 %.

As all the mails say above, there is a price, paid by our taxes

Answer 8

Rillifane gave the most accurate answer. We don't have a socialized health care system as in the UK, we have a "socialized" health insurance system. It means we are free to see any doctor we want or go to any hospital/clinic, which is not the case with the American HMO system where you have to stay within a network. The state health insurance reimburses your expenses up to 65 to 100 %. Most things are paid back 70 or 80 %. (People below a certain income level get free health care). To cover the rest, you can purchase a private health insurance (mutuelle complémentaire) if you want, but prices range from 10 € a month for a student to 50 €/month for a family for a super fancy health insurance.

If you have no private health insurance and have to pay out of pocket the remaining 20% of a bill, if you go to hospital for 5 days to get surgery for appendicitis, it will cost you 614 euros. So nothing to do with US prices. But technicaly, since most people get the complementary insurance, yes, most people get 100% of their cost reimbursed.

Addition: I am continuing as I didn't get time to write more earlier. That's for the upside: great medical system (ranks #1 in the world), everyone is equal in the face of healthcare regardless of income. It is cheap, easily available (no waiting lists as in Canada or the UK). The downside is explained in the next message. I wouldn't change the system in its form, but I would give tax cuts to small companies and also ask individuals for a little more effort: I don't see anything wrong with paying a co-pay of 5 euros per visit instead of 1, it would still be affordable to the vast majority and would make people feel more responsible. Also a lesson could be learned from the British and US systems of delivering drugs: in France, if the doctor prescribes a pill twice a day for 7 days, you should get 14 pills, right? That's what GB and US pharmacies will give you. In France if the packaging comes in a pack of 30, you'll get the whole box of 30. Another downside is a deficit of billions of euros in the health care system, which will have to get solved at some point. But even though I would agree with some reforms to avoid waste and a burden on employers, I wouldn't change the system for a British or American one. I live in the US and find it appalling that health doesn't come first, only money matters. In the UK, the system is OK for primary care (although they cannot choose their doctor, which I wouldn't like) but people have to wait months/years to get surgery. Therefore the richest go to private clinics, the middle class go to French hospitals (which cost 3 times less than the private GB hospitals), and the poorer are stuck on the waiting list. So I really like the French system, we should just do more to avoid waste.

But as Rillifane pointed out at the end of his answer, it is a misconception to think that the French spend more on health. It is the opposite, the US is the country that spends the most on healthcare, and yet, the one where people get the least for their money.

College tuition is free and once again I think it is great. Downside as explained by Rillifane is that therefore colleges are underfunded and some are overcrowded. The educational level is very good at the undergraduate level and far better than in the US on average. But when it comes to doctorate's degrees and above, too little money is injected into research and therefore it can be frustrating to students who will end up doing a post doc in the US. At the higher level, French universities will easily compete with the average US one, but not with the ivy league ones. A reform is in progress right now to allow some private funding. I have no opinion on the matter from lack of information.

As for child care, I do not know enough to talk about it.

Second addition, to Graham I: 1) it is not true that the poorest cannot wait to be reimbursed. First of all, now you (rich or poor) don't pay and then wait for the reimbursement (which used to take only a few days anyway), you give your electronic health insurance card 'carte vitale' and the bill will be charged directly to the health insurance. And even in the past when you had to pay first and then submit your claim, the poorest people were exempt from this system. They received care without having to pay and then it was up to the doctor to submit the paperwork to get their payment. 2) education is free at all levels, university included, not just until high school.

And I would like to correct Mayali's statement about the referral to see a specialist (which was introduced very recently as an attempt to save money):  you still get reimbursed if you see a specialist without going through your primary care physician, but at a lower percentage. Which means you have to pay a few euros. Still heaven compared to the US system and still only a tiny fraction of what a co-pay would be here.

Answer 9

Nothing is "free".....it just means someone else is paying for....