4 Myths about the French healthcare system you should stop believing

Written by Diane on. Posted in on life in France

French healthcare myths you should stop

After almost 4 years of living in France and experiencing French healthcare first-hand — as well as seeing the experiences of those around me — I’ve concluded that many aspects of the country’s medical system here are superior to healthcare in the US. In my experience, doctors have been patient, kind and thorough overall. Quality of care is subjective and largely depends on the doctor — I’ve experienced both sides of the coin. I’ve had great and horrible care in the USA and in France, but overall I’m extremely happy with the French healthcare system, but that’s not to say it’s perfect…. not by a long shot.

I am often asked what I think of French healthcare. People are genuinely curious about what my experience has been like. Other times people make comments praising French healthcare or ripping it a new one, but they’re sometimes misinformed.

So to clear up the myths floating around about the French healthcare system, I invite you to READ ON…

French healthcare myths

Let me kick this off by saying my thoughts here on the French medical system are based on my own personal experiences. I don’t claim to know everything (far from it!). Also, healthcare is a complicated and emotional topic so please keep your comments respectful if you choose to leave one below. You can read more about how healthcare works in France here (in French).

First, to give you some background, the French medical system is a universal service comprised of a network of public and private hospitals, doctors and other medical service providers. When you go to the doctor in France, payment is expected at the point of service and people in need of healthcare are not turned away due to age, employment status or pre-existing conditions. David Lebovitz has a nice post linked here about French healthcare for travelers, so check it out.

OK, onward and forward…

Myths about the French healthcare system:

french healthcare myths

Myth: That everyone gets coverage.

Only French citizens and legal French residents are covered by the French healthcare system — basically those that are paying into the system. If you’re visiting France as a tourist from the USA and break your leg, you will absolutely be treated, no questions asked, but you’ll be responsible for all costs. In many cases your American insurer will cover the cost but sometimes they won’t. Granted, the costs are much less than you’d pay in the US but they’re still your responsibility.

One fantastic thing I want to point out is that if you lose your job, you don’t lose your health insurance in France. Many times in the USA, if you lose your job, you lose your (and your family’s) health insurance along with your paycheck. The French system is independent of one’s employment status — and doesn’t discriminate based on age, wealth or your social class — so even if you’re unemployed, you don’t have to worry about bankrupting your family if you need surgery or another costly medical procedure.

For anyone who gets anxiety thinking about healthcare or has ever struggled with coverage, the fact that your job doesn’t factor in to you and your family’s health plan is a major plus. From a human rights perspective, this is the way to go. “Access to health care appears to have produced a healthier nation,” writes the WSJ. “France’s infant death rate is 3.9 per 1,000 live births, compared with seven per 1,000 in the U.S. The country has more hospital beds and doctors per capita than the U.S., and a markedly lower rate of mortality from respiratory disease. And France spends less (10.7% of gross domestic product) on health care than the U.S. (16% of GDP).” France’s system is not without fault though.

A visit to the French dentist… things you never want to hear your dentist say >>

Myth: That it’s free (or really cheap).

This one grinds my gears! I just heard it last week from a healthcare professional in the USA and it might be one of the most widely believed myths about French healthcare! Compared to the cost of care in the USA, French healthcare costs are without a doubt more affordable. But free or really cheap? No. Let’s not forget that the French pay heavy social charges (plus income tax, real estate tax, TV tax that further diminish take home pay) — they pay into the system, along with employers on the back end. So even though the flat fee of 23 euros is cheap for a general doctor’s visit (and most of that is reimbursed by the social security system, and even more if you pay for supplementary insurance) the French do pay a hefty sum for their healthcare but it’s not when services are rendered. Every paycheck you get shows the deductions for social charges (including healthcare) and you pay into the system whether you’re sick or not.

Beyond paying into the system, French health services are not always low cost.

Many seemingly regular medicines, tests and services are NOT covered and have to be paid out of pocket.

To give you some context, a French family member had a colonoscopy recently and the procedure itself was covered but the anesthesia was not. Most people opt for anesthesia and end up paying out of pocket for their comfort. Some of these charges are reimbursed by the patient’s mutuelle (supplementary insurance most French people pay for to pick up the difference between what’s reimbursed and the full cost of the service). Birth control pills are also not covered and you pay the cost (cheaper than the US though) out of pocket. Same with any specialized blood testing for allergies, etc. Case in point? A family member’s gluten sensitivity blood test — 90 euros out of pocket, 0 reimbursed. If you’re dying of cancer, you’ll be taken care of but if you have a chronic, non-life threatening illness or something that requires specialists who order out-of-the-ordinary tests, or alternative providers in general, get ready to cough up the cash. That said, medical bankruptcies don’t exist in France so even if you are paying out of pocket, you won’t lose your house.

Going to the doctor in France… what you need to know >>

Myth: That the healthcare is great.

That’s a really loaded statement. “Great” is subjective and wholly depends on the facility, doctor and your ailment. There are great and not-so-great practitioners everywhere in the world. Let’s not fall for the grass is always greener syndrome. What does “great” mean to you? I may be biased but I firmly believe that French healthcare is great for emergency and routine coverage. If you need emergency surgery or have aggressive cancer, the French system has you covered, as noted above. Along with that, if you’re reasonably healthy and see the doctor once a year and rarely need specialists, the French system is great as well. But if you need to see specialists regularly, they’re often difficult to book an appointment with due to overcrowding (6-month wait for new patients was the case for me at the dentist and dermatologist) and if you do get in, the doctor may be rushed.

To be fair, this is often the case in the US too. My dermatologist in New Jersey was impossible to get an appointment with and when you did get in, she spent a rushed 5 minutes with you. And billed the insurance obscene amounts. Does this happen in France? Sure (not the obscene amounts part though). But I have to say that I’ve also spent 45 minutes with my doctor who was patient and thorough. Although now he has too many patients and is often rushed.

Myth: That it’s easy to see specialists.

Unlike general practitioners, specialists are allowed to set their own rates beyond the standard rate and only a portion of whatever the government deems a reasonable charge is reimbursed. So if the regular cost to see a dermatologist is 45 euros but yours charges 70 euros because he’s in demand, you’re only reimbursed a portion of that baseline charge of 45, not the entire 70. As noted above, it’s sometimes very difficult to get in to see a specialist if you’re new to an area and/or your condition is annoying but not urgent. You’re going to wait. Many times you’ll need a referral from your GP to see a specialist in a timely manner and to be reimbursed. Lesson here? It’s best to learn how to finesse people over the phone sooner than later. Sometimes when the gatekeepers pity you, they’ll be more likely to help — that goes double if you’re being polite.

***

There are pros and cons to everything in life and the French healthcare system is no exception. The next time you hear someone talking about French healthcare, perk your ears up and see if they know fact from fiction!

How’s your experience been with French healthcare?

Lou Messugo
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Comments (20)

  • Lynn

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    I feel like I could write a novel here, but tl;dr I LOVE the French healthcare system! Maybe it’s because I’m in Paris, but I haven’t had a problem booking dermatologists (it depends on which one) or eye doctors. I used doctolib.fr and got an eye doctor appointment the next day when I self-diagnosed a scratched cornea (it was conjunctivitis) and same with a gynecologist my friend recommended. I need to get two crowns replaced and the estimate is 2000€ but after reimbursement my cost will be 200€ because I have a mutuelle.
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    • Diane

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      Awesome, so glad you’ve had a good experience too! It’s nice to not have to worry how much my doctor’s visit will cost or how much special tests will cost. Such a relief!

      Reply

  • Shannon

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    I agree with these myths! Though luckily, as we’re in a big city and not a “desert medical”, we never have huge wait times.

    However, if you’re paying for your birth control, you may want to talk to your doctor about switching. I never pay for mine. It’s completely covered. Even when I didn’t have a mutuelle, I only paid that part (about a euro). Unless you’re super sensitive and need to be on a specific type, there are options that are covered.
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    • Diane

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      Interesting, thanks Shannon. I will look into that. I was under the impression (both from my pharmacist and doctor) that the pill was NOT reimbursed at all, ever. Maybe they are misinformed? In any case, will get to that bottom of that. Thank you!

      Reply

      • Karine

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        It’s depend on the brand of your pill. Some pills are reimbursed, some not (I don’t know how they choose…).

        It’s funny I just post on my blog my last visit to a physician in the US and how we feel when we received our first bill.
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  • Bob

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    Do you mind saying how much the anesthesia for your family member’s colonoscopy cost? I’ll need that in a few years and it will be good to know for comparison. Last year in the US my health insurance company initially refused to pay the 1000 dollar bill for anesthesia but eventually covered the total cost. Thanks!
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    • Diane

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      Hi Bob, the cost of anesthesia is nowhere near what it is in the USA. I don’t know if it’s an apples to apples comparison (not sure of the exact drugs involved but I believe it was twilight sedation for the colonoscopy) but I know the family member paid 40 euros outside of the regular fees. It was a special fee for the anesthesiologist but I think his mutuelle picked up the rest of the cost. You have nothing to worry about w/routine procedures like that in France 😉

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    • Diane

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      If it is of any interest to you I have just had a colonoscopy in Angouleme and I decided not to have an anaesthetic. It was no problem and I could watch the screen as to what was happening. I did start having a few cramps after a while and the surgeon just gave me an injection to relax the muscles. I would never go with anaesthetic if I had to have it done again.
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  • MJ

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    As a french living in the US, it is very interesting to read from the opposite point of view. I agree with your article, but I did not test the american medical care yet, so I cannot compare it.

    Reply

    • Diane

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      Hello, in the USA as long as you are employed (or your partner is) by a company that provides great health coverage and you don’t lose your job, you’re fine most of the time. That said, I know people who have “great” USA insurance but still have a large copay (out of pocket cost) for hospital visits. A friend in the US had surgery and his procedure was $40,000 and his portion out of pocket was still several thousand dollars. A friend had pregnancy complications, a c-section and the baby stayed in the NICU. All that was billed to the insurance at over $100,00, with out of pocket costs still around $8000, all with insurance. It’s hard to speak generally about the US system because there are so many different plans and coverage %. Without insurance though, it’s very, very hard to pay for care especially if you have an illness that requires frequent medical visits and medication. Thank you for checking out the post!

      Reply

  • Ze Coach

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    I miss the French system. When I was in France I never worried about the cost to have me and my family taken care of in case of big trouble. Over here in the US, I feel sometimes that it’s like going to the garage repair. They need to make money and sometimes you might be advised for something you don’t need. Also, they need to make money to pay their insurance. Over here, you are advised to shop for your health. Health is still the priority but the cost is a big factor in decision making. If you want to be prepared to worst case scenario in the US, it costs a lot in fact. People can fell in poverty because of a life accident. Now in France, because the cost is almost hidden, the problem is that the system is in debt. Health should not be a business like any other to my mind so French system is closer to the ideal system for me.

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  • Jo-Anne

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    Thank you I often wonder about health care in other countries as what you hear isn’t always the way it is.
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  • Zhu

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    I strongly support tax-funded healthcare systems like in France or in Canada. I can’t imagine having to deal with private insurances like in the US. It’s just… yeah, I can’t find a single good thing about it. Sorry. Not anti-American, BTW, it’s a country I like a lot and there are many good things there… but I don’t think the healthcare system is one of them.

    That said, the French and the Canadian systems aren’t perfect either. I love the fact that we don’t have to pre-pay in Canada (you just show your healthcare, either it’s covered, either it isn’t). However, you are often rushed as a patient and getting a referral for a specialist can be very difficult.

    To support your first point, I am no longer covered in France, even as a French national, because I no longer live there.
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  • Phoebe @ Lou Messugo

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    This seems to me to be a balanced view of French healthcare. From a British perspective I find access to specialists very easy (the fact that you can see one even if there’s a wait to me is great! In UK you have to be referred and many GPs won’t until you’re on death’s door!) From a personal point of view all of my experiences have been good (2 pregnancies especially). But of course nowhere is perfect and there are certainly some less than “sympa” doctors out there. Thanks for linking up tooo #AllAboutFrance
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  • Wander Mum

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    Very interesting post! Really good to hear the myths deconstructed. Every country has slightly different healthcare systems and there are undoubtedly pros and cons for all. #allaboutfrance

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  • Christy Swagerty

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    Great piece, Diane! I had positive (albeit sometimes awkward) experiences with health care in France. I’d say my biggest problem was that my carte vitale never arrived after 3 years of continually reprocessing and resubmitting my documents! I got my card in Germany in 3 weeks! Just a severe run of disorganization and bad luck! 🙂

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  • Katherine Forshaw

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    When you first come to live in France the health care system seems so complex but I guess that’s the same with everything when you move to a new country & system. The system does still fox me a bit, sometimes you pay up front and it gets reimbursed, other times you don’t pay a penny! The treatment I have had has been exceptional, since moving here I’ve had cataract operations on both eyes, and another op earlier this year – I give the French system & level of care a big thumbs up – especially when compared against the UK!

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  • curtis bausse

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    Quite agree that it’s certainly superior to the UK in terms of quality of care. The only thing that annoys me is the vast quantities of medicine that seem to accumulate in our cupboard no matter how much we try to restrict them. Expensive, wasteful and unnecessary.

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  • Rosie @Eco-Gites of Lenault

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    I have to say that we have made good use of the French medical system since we have moved over here (heart problem, fractured spine, broken arm, grommets, preventative health screening, badly cut arm etc) and whilst we have had to pay our for some parts the service overall has been excellent. We waited 18 months even to see an ENT specialist for grommets in England yet here within 3 weeks our second son had had his operation. But I do agree with Curtis over the amount of medicines and dressings you end up buying! #AllaboutFrance
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  • Ben

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    Hi,
    I consider myself very lucky to live in France. You see, I’ve been tetraplegic for 13 years now and I’ve never had to pay for healthcare, physiotherapie or even personal assistance. Even when I need furniture (like a wheelchair or anything else), it’s taken in charge. I even had a pansion before I found a job.
    How is it in the US?
    Sorry for the mistakes

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