{"id":722,"date":"2008-11-10T13:04:00","date_gmt":"2008-11-10T17:04:00","guid":{"rendered":"http:\/\/blog.cmhughesmd.com\/?p=722"},"modified":"2008-11-10T13:04:00","modified_gmt":"2008-11-10T17:04:00","slug":"france-oecd-summary","status":"publish","type":"post","link":"http:\/\/blog.cmhughesmd.com\/?p=722","title":{"rendered":"France &#8211; OECD Summary"},"content":{"rendered":"<p>Summaries of summaries of healthcare systems based on the Commonwealth Fund reports.<br \/>Author(s) of <a href=\"http:\/\/www.commonwealthfund.org\/topics\/topics_show.htm?doc_id=674975\">the originals <\/a>are: <br \/>Karsten Vrangbaek, Isabelle Durand-Zaleski, Reinhard Busse, Niek Klazinga, Sean Boyle, and Anders Anell <\/p>\n<p>France<br \/>\u2022 79% of all care is publicly financed<br \/>\u2022 Employer and employee payroll taxes account for 43% of the funding.  The employer pays 12.5% of payroll and the employee pays 0.75% of payroll.<br \/>\u2022 Part of the national income tax goes to funding health care and accounts for 33% of the funding.<br \/>\u2022 Tobacco and alcohol taxes supply another 8% and state subsidies and other social security taxes provide another 10%<br \/>\u2022 Coverage includes everything except dental and eye.<br \/>\u2022 Cost-sharing occurs through coinsurance and co-pays and extra\/balance billing<br \/>\u2022 Out-of-pocket expenditures account for 7.4% of the total health expenditure<br \/>\u2022 Private health insurance accounts for 12.8% of the total health expenditure<br \/>\u2022 The public funding goes to public health insurance funds with membership based upon occupation<br \/>\u2022 Benefits\/prices\/cost-sharing levels are determined, since 2004, by the national Union of health insurance funds (UNCAM)<br \/>\u2022 Low income persons also get free complementary-supplementary coverage including dental and eye and they qualify for no balance billing<br \/>\u2022 Private insurance is like our supplemental policies.  It reimburses for the cost-sharing elements of the national plan.  This is usually provided by employment-based insurers called &#8220;mutuelles&#8221; . 90% of the population gets this.  So far there is only a minimum competition in this market.<br \/>\u2022 Physicians, non-hospital-based, are self-employed and fee-for-service.  Hospital-based physicians are salaried.<br \/>\u2022 Two thirds of hospital beds are either government-owned or nonprofit.<br \/>\u2022 One third hospital beds are private located in for-profit clinics and, I believe, in hospitals as well.<br \/>\u2022 Hospital reimbursement is moving to a DRG style system.  Hospitals do get subsidies for research and teaching and emergency care.<br \/>\u2022 There are some cost controls in place.  Controlling formularies a big issue at the present time according to <a href=\"http:\/\/cmhmd.blogspot.com\/2008\/04\/interview-with-dr-calloch-of-frances.html\">my interview with Dr. C&#8217;alloch in Paris.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Summaries of summaries of healthcare systems based on the Commonwealth Fund reports.Author(s) of the originals are: Karsten Vrangbaek, Isabelle Durand-Zaleski, Reinhard Busse, Niek Klazinga, Sean Boyle, and Anders Anell France\u2022 &hellip; <a href=\"http:\/\/blog.cmhughesmd.com\/?p=722\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;France &#8211; OECD Summary&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"sfsi_plus_gutenberg_text_before_share":"","sfsi_plus_gutenberg_show_text_before_share":"","sfsi_plus_gutenberg_icon_type":"","sfsi_plus_gutenberg_icon_alignemt":"","sfsi_plus_gutenburg_max_per_row":"","footnotes":""},"categories":[55,131,60],"tags":[],"class_list":["post-722","post","type-post","status-publish","format-standard","hentry","category-france","category-oecd-summaries","category-us-world-health-care-policy"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/722","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=722"}],"version-history":[{"count":0,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=\/wp\/v2\/posts\/722\/revisions"}],"wp:attachment":[{"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=722"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=722"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.cmhughesmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=722"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}