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The BBC's Jamie Coomarasamy
"The French healthcare system has been rated second to none"
 real 28k

WHO Director General, Gro Harlem Brundtland
"It is a very differentiated system"
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Wednesday, 21 June, 2000, 06:23 GMT 07:23 UK
French health care 'best in world'
Doctor with patient
French doctors are in plentiful supply
France leads the world in health care, says the World Health Organisation in a major report, which rates the UK 18th and the US 37th - despite being the country which spends the most per head.

The rating is based on a comprehensive assessment of medical treatment, including factors such as availability of medical insurance and pharmacies.

Italy comes second in the WHO league table, with Singapore, Spain, Austria and Japan among other countries in the top 10.

Making the diagnosis

Various criteria were applied to assess different countries' health care systems. They include:

  • The overall level of health in the population
  • health inequalities within the population
  • health system responsiveness and patient satisfaction
  • distribution of financial burden

The study echoes the findings of opinion polls carried out in France, where people consistently register a high degree of satisfaction with their level of health care.

By and large, hospitals are clean and efficient, waiting lists are short, general and specialist doctors are in plentiful supply and, above all, in a country that prizes its spirit of solidarity, the benefits are universally available.

The system is based on compulsory insurance.

Separate budget

Anyone with a job pays part of his or her salary into the Secu, or social security, whose budget is then kept entirely separate from the rest of government expenditure.

In addition, most people top up with added insurance at profession-based associations, called Mutuelles.

The result is that 100% of the cost of the majority of normal medical procedures is promptly reimbursed, with a sliding scale of repayments for non-essential treatment, like orthodontistry.

The abiding criticism of the French system is, in fact, that it's too lavish.


Because of the universal cover, there is a huge incentive to become medical consumers, with the result that the French have one of the highest levels of drug prescriptions in the world.

Only recently has the government started to persuade people to start taking cheaper generic drugs instead of the identical branded products which the system encouraged them to indulge in.

That criticism was particularly acute when the health system was running at a massive deficit.

But since last year that is no longer the case, so the French really have very little to complain about.

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