Sustaining Universal Health Coverage in France : A Perpetual Challenge

While universal health coverage (UHC) offers a powerful goal for a nation, all countries-irrespective of income are struggling with achieving or sustaining UHC. France is a high-income country where HC is in effect universal. Health-related costs are covered by a mix of mandatory social health insurance (SHI) and private complementary schemes, while benefit packages are comprehensive, uniform, and of good quality. France provides some of the highest financial protection among countries in the Organization for Economic Co-operation and Development (OECD). Still, under pressure to sustain UHC without compromising equity of access, the system has been fine-tuned continually since inception. Much can be learned from France's experience in its reforms toward better fiscal sustainability, equity, and efficiency. The main purpose of the study is to assess major challenges that France has faced for sustaining UHC, and to share its experiences and lessons in addressing system bottlenecks to benefit less developed countries as they embark on the path to UHC.

Bibliographic Details

Main Authors:	Barroy, Helene, Or, Zeynep, Kumar, Ankit, Bernstein, David
Language:	English en_US
Published:	World Bank Group, Washington, DC 2014-06
Subjects:	ABILITY TO PAY, ACCESS TO HEALTH CARE, ACCESS TO HEALTH SERVICES, ACCESSIBILITY OF CARE, ACUTE CARE, ALCOHOL CONSUMPTION, ALCOHOLISM, ALLOCATIVE EFFICIENCY, AMBULATORY CARE, AMBULATORY SECTOR, BASIC HEALTH SERVICES, BREAST CANCER, BURDEN OF DISEASE, CANCER PATIENTS, CAPITAL INCOME, CARDIOVASCULAR DISEASES, CARE TECHNIQUES, CATASTROPHIC HEALTH SPENDING, CERVICAL CANCER, CHOICE OF PROVIDER, CHRONIC DISEASES, CHRONICALLY ILL PATIENTS, CLINICAL GUIDELINES, CLINICAL QUALITY, CLINICIAN, CLINICIANS, CLINICS, COMPETENCIES, COST CONTROL, COST OF HEALTH CARE, COST OF SERVICES, COST SHARING, COST-EFFECTIVENESS, COST-EFFICIENCY, DEATHS, DECISION MAKING, DELIVERY SYSTEM, DENTAL CARE, DENTAL HEALTH, DENTAL HEALTH CARE, DIABETES, DIAGNOSIS, DIAGNOSTIC SERVICES, DIRECT COSTS, DOCTORS, DRUG CONSUMPTION, DRUGS, EMERGENCY CARE, ENROLLEES, ENTITLEMENT, EXPENDITURE CONTROL, FEE FOR SERVICE, FEE-FOR-SERVICE, FINANCIAL CONSEQUENCES, FINANCIAL IMPACT, FINANCIAL INCENTIVES, FINANCIAL PROTECTION, FINANCIAL RESOURCES, FINANCING HEALTH CARE, FLAT RATE, FREE CHOICE, GAMBLING, GENERAL PRACTICE, GENERAL PRACTITIONERS, GLOBAL BUDGETS, GROWTH OF HEALTH EXPENDITURE, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE DELIVERY, HEALTH CARE FACILITIES, HEALTH CARE FINANCING, HEALTH CARE NEEDS, HEALTH CARE NETWORKS, HEALTH CARE POLICIES, HEALTH CARE POLICY, HEALTH CARE PROFESSIONALS, HEALTH CARE PROVIDERS, HEALTH CARE PROVISION, HEALTH CARE RESOURCES, HEALTH CARE SERVICES, HEALTH CARE SPENDING, HEALTH CARE SYSTEM, HEALTH CARE UTILIZATION, HEALTH CENTERS, HEALTH COVERAGE, HEALTH ECONOMICS, HEALTH EXPENDITURE, HEALTH EXPENDITURE BY SOURCE, HEALTH EXPENDITURE GROWTH, HEALTH EXPENDITURES, HEALTH FINANCING, HEALTH INEQUALITIES, HEALTH INSURANCE, HEALTH INSURANCE COVERAGE, HEALTH INSURANCE FUNDS, HEALTH INSURANCE MARKETS, HEALTH INSURANCE SYSTEM, HEALTH MANAGEMENT, HEALTH NEEDS, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH POLICY, HEALTH PROFESSIONALS, HEALTH PROMOTION, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE PROVIDERS, HEALTH SERVICES, HEALTH SPECIALIST, HEALTH SPENDING, HEALTH STATUS, HEALTH SYSTEM, HEALTHCARE, HIGH BLOOD PRESSURE, HOSPITAL BEDS, HOSPITAL CARE, HOSPITAL EXPENDITURE, HOSPITAL MANAGEMENT, HOSPITAL SECTION, HOSPITAL SECTOR, HOSPITALISATION, HOSPITALIZATION, HOSPITALS, HOUSEHOLD INCOME, HUMAN DEVELOPMENT, IMMIGRANTS, INCOME, INCOME COUNTRIES, INCOME DISTRIBUTION, INCOME GROUPS, INDEXES, INDUCED DEMAND, INFORMATION SYSTEM, INSURANCE CONTRACTS, INSURANCE COVERAGE, INSURANCE PREMIUMS, INSURERS, LIFE EXPECTANCIES, LIFE EXPECTANCY, LOW INCOME, MEDICAL ACTIVITIES, MEDICAL CARE, MEDICAL DEVICES, MEDICAL FEES, MEDICAL INFORMATION, MEDICAL PERSONNEL, MEDICAL STAFF, MEDICATION, MENTAL ILLNESS, MINISTRIES OF HEALTH, MONITORING MECHANISMS, MORBIDITY, MORTALITY, NATIONAL HEALTH, NATIONAL HEALTH INSURANCE, NATIONAL HEALTH INSURANCE FUND, NURSES, NURSING, NURSING HOMES, NUTRITION, OUTPATIENT CARE, PATIENT, PATIENT OUTCOMES, PATIENTS, PHARMACEUTICAL COMPANIES, PHARMACEUTICAL INDUSTRY, PHYSICIAN, PHYSICIANS, PHYSIOTHERAPISTS, PHYSIOTHERAPY, POCKET PAYMENTS, POLIOMYELITIS, PREGNANT WOMEN, PRESCRIPTION DRUG, PRESCRIPTIONS, PREVENTIVE CARE, PRICES OF HEALTH CARE, PRIMARY CARE, PRIVATE CLINICS, PRIVATE HOSPITALS, PRIVATE INSURANCE, PRIVATE SECTOR, PRIVATE SECTORS, PROBABILITY, PSYCHIATRISTS, PUBLIC HEALTH, PUBLIC HOSPITAL, PUBLIC HOSPITAL STAFF, PUBLIC HOSPITALS, PUBLIC INSURANCE, PUBLIC POLICY, PUBLIC SECTOR, PUBLIC SPENDING, QUALITY OF CARE, REFUGEES, REHABILITATION, REIMBURSEMENT RATES, SCREENING, SERVICE DELIVERY, SICKNESS FUNDS, SMOKING, SOCIAL HEALTH INSURANCE, SOCIAL INSURANCE, SOCIAL INSURANCE SYSTEM, SOCIAL SECURITY, SOCIAL SECURITY FINANCING, SURGERY, TREATMENTS, TUBERCULOSIS, UNEMPLOYMENT, USE OF HEALTH SERVICES, VACCINATION, VISITS, WORKERS, WORKING CONDITIONS,
Online Access:	http://documents.worldbank.org/curated/en/2014/06/20279044/sustaining-universal-health-coverage-france-perpetual-challenge https://hdl.handle.net/10986/20754
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