ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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France: Universal Medical Coverage

The newly-introduced Universal Medical Coverage Scheme is ostensibly meant to ensure that everyone regardless of whether they are employed or not, is assured of access to medicare. But it has many critics.

The Universal Medical Coverage (UMC) Scheme is going to cost the  French state nine billion francs. This is nine billion francs paid by the taxpayer to the state. The state will pay this nine billion francs to the Caisse Nationale d’Assurance Maladie des Travailleurs Salaries (National Fund for Medical Insurance of Salaried Workers) (CNAMTS) and private mutual funds and insurance companies. These organisations, in turn, will pass on this money minus their profit or administration expenses to the health sector: pharmaceutical companies, doctors, medical analysis laboratories and, with this law, dentists and opticians. We know that the health sector needs growth in sales. For this, they need either a price increase or an increase in quantity consumed. To avoid inflation, the government would prefer the latter. An increase in consumption can either be more consumption per head or consumption by more people. Since France is already a world leader in consumption per head of medicines, especially tranquillisers, the French are already painfully aware of their neurotic image and would not like to tarnish it further. The increase in sales must be directed to those who are not consuming at all or not enough (although even this will increase the average quantity consumed per person used for international comparisons). Who are the culprits who are lowering French consumption of medicines from its potential? The healthy, the very healthy, who don’t need it and the poor, the very poor, who can’t afford it. While pollution may one day crack the former, it seems reasonable that the government finds ways to help the poor consume. This is what a political settlement is all about. Help the poor consume and help the rich grow. The UMC is a way of funding the consumption of medicines by the poorest courtesy of the taxpayer.

The government has already taken steps to get the poorest to consume. First, it allowed non-working people to take up personal medical insurance. Of course, this alternative was so expensive (average of FF 15,000 per person per year) that only 50,000 took it up. In fact, one would have to be really sick really often for it to be a rational decision. Thereafter the government made personal medical insurance free for the very poor, notably those on the Revenu Minimum d’Insertion (minimum dole for the long-term unemployed to reinsert themselves into the system) (RMI), covering another 5,00,000 people. The tab of FF 7.5 billion was picked up by the Caisse Nationale d’Allocations Familiales (National Fund for Family Allowances) (CNAF) (FF 3 billion), the department (FF 4 billion) or the Fonds de Solidarite Vieillesse (Old-age Solidarity Fund) (FSV) (FF 0.5 billion). Still, they did not consume. Why?

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