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READER INSIGHTS

‘We moved here for the healthcare’: How foreigners view France’s social model

As France mulls cuts to some services to reduce the country’s deficit, readers reveal their experiences of health and social care here.

'We moved here for the healthcare': How foreigners view France's social model
An ambulance parked at the entrance of the Hospital Pierre-Paul Riquet of the University Hospital Centre (CHU) Purpan in Toulouse. (Photo by Lionel BONAVENTURE / AFP)

From free taxi rides for patients to state grants for holidays and concert tickets, via a robust system of benefits and healthcare, the French social model – funded by taxes – has long been renowned as a generous one.

But finance minister Bruno Le Maire has indicated that some services will need to be cut as the French deficit is high and steadily rising.

So we asked our readers – is France’s social model really too generous? Or does it serve the people who live here well, in exchange for their hefty tax contributions?

Healthcare

We started off by asking people about their experiences of French healthcare, and whether they believe any changes should be made.

Overall, people were very positive about the French health system with most saying they had had good experiences and several people expressing gratitude for French medics who had saved their lives.

Pamela, from Bayeux, wrote that French benefits and healthcare services are, “Excellent”. “I pay a lot of tax and cotistations,” she wrote, “I feel like I get a fair return on this.”

Liz Barclay, who lives in Aveyron, wrote that an American friend’s six-day hospital stay and surgery following a heart attack cost around €11,000 in France compared to around $250,000 in USA. The care the friend received was ‘highly praised’ by an American cardiologist, she wrote.

She added that, “Regular doctor visits at €25 or even €30 seem very cheap.”

In fact, the general consensus among the responses is that care and services are mostly excellent – Alphonse Thompson went so far as to say it was: “Excellent, humane and a model for the Anglophone world”.

And Eric Stillwell, from Lot, said: “We moved here for the healthcare and believe it should be the model for more countries.”

D Packman, in Paris, wrote about the “Quality services, reasonable costs” of social and healthcare services in France.

READ ALSO How to get a carte vitale in France and why you need one

American Amy Freeman said: “I have used the system three or four times. I love the ease of making appointments and the bills were very low. I have never abused the system or asked for more than I needed. Probably because I am American and am terrified of getting a massive bill. I can’t seem to shake that mentality no matter where I live.”

Social benefits

France’s social benefits are also potentially in line for cuts, especially unemployment benefits, so we asked our readers who had used those services what they thought.

A Var reader pointed out: “[U]nemployment benefits are not unreasonably generous and only available if sufficient working contributions prior to losing a job.”

Richard Romain, who lives in Aude, described the French model as, “socially inclusive and allows people to get into employment”.

He added: “My employer received a grant over five years for employing me as I am disabled. I also got 100 percent grant for adapting my place of work.”

And Andy Parsons, who has lived in Calvados since 2007, said the system was: “Easy and generous. As a full time carer for a three children, one of whom has disabilities, the allowances were generous and the tax breaks enormous.”

But not everyone agreed. Aditya Das, who moved to Lyon from India, was one of a few respondents who felt France’s social model was ‘too generous’. Das argued that “some undeserving people” benefit from a combination of state aid that keeps, “able bodied people from working”.

And A McKnight, from Argenteuil, wrote: “Every area of benefits goes too far – there need to be clear conditions and termination points set in place.”

Carol Schoen, who lives in Strasbourg, argued unemployment payments were too high: “There is too much abuse and not much incentive to get a job … [and] child allowances are too generous and don’t always benefit the children.”

And Ceinwen Reeves Izzard, from Dordogne, said that the model may be weighted against some, pointing out the, “[l]ack of generosity in sick pay for self-employed people who are too ill to work when others get spa treatments on prescriptions”.

Cuts

And finally the million euro question – is there anything that is too generous and should be cut?

While some argued that unemployment benefits are too generous and don’t incentivize work, others looked for savings amid healthcare. 

Reimbursed taxi costs for certain appointments, prescriptions for spa treatments and over-medication were causes for concern.

READ ALSO How to get free transport to medical appointments in France

Most people, however, advocated limiting or means-testing certain services, rather than axing them altogether.

“France could certainly eliminate free taxi rides to appointments for people who can drive themselves or can easily find a ride,” wrote Barclay, an view echoed by Pamela, who added: “It’s more the abuse that bothers me than the existence of the service. I see a lot of Britons living here taking the mickey with it.”

Several readers – especially those living in rural areas – told us they had used the taxi service to travel to vital medical appointments including cancer treatments. 

Several people also flagged up waste when it comes to medication, or just general over-prescribing (and it’s true that the French are among the most highly medicated nations in the world).

Robert Hodge, living in the Vendée, said: “The amount of medication issued by pharmacies needs to be limited to that which is actually prescribed. Two pills a day for six days should be 12 pills and not 20 just because they come in boxes of 10.”

Ceinwen Reeves Izzard added: “They are overly keen to prescribe MRIs, I have had multiple. They oversubscribe medication. I have lots of morphine locked in a safe because the pharmacy wouldn’t take it back.”

Matthew Davison agreed, adding: “The big one is medication. My doctor might prescribe 3 pills a day for 5 days, but the pharmacy will give me the double because that’s the amount in one box. This creates so much waste. I have a cardboard box filled with leftover medicine I didn’t need.”

Member comments

  1. Like any system there is room for abuse. Overly generous unemployment may (having witnessed) encourage able bodied people to not work. But no longer having sick pay for first couple of days due to abuse of system is silly. causes people to go in sick. so spreading germs. Tricky to find a balance but overall a much better system than in the US.

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LIVING IN FRANCE

Why you might get a letter about French benefits

France is introducing stricter residency requirements for certain benefits, including those that foreigners in France can qualify for, and has begun sending letters out to recipients.

Why you might get a letter about French benefits

In April, the French government passed a decree that will tighten up residency requirements for different types of benefits, including the old-age top-up benefit.

Previously, the rule for most benefits was residency in France for at least six months of the previous year to qualify, though some required eight months and others, like the RSA (a top-up for people with little to no income) requires nine months’ residency per year.

However, the government announced in 2023 its intention to increase the period to nine months for several different programmes – which was put into decree in April – in an effort to combat social security fraud, as well as to standardise the system.

The changes, which will go into effect at the start of 2025, do not affect access to healthcare – foreigners can still access French public healthcare as long as they have been resident here for a minimum of three months. 

Similarly, the rules for accessing chômage (unemployment benefits) have not changed yet. Currently, you must have worked for at least six months out of the last 24 months to be eligible, as well as meeting other criteria including how you left your previous job.

This may change in the future, however, with the French government poised to reform the unemployment system again.

READ MORE: How France plans cuts to its generous unemployment system

Which benefits are affected?

The old-age benefit – or the ASPA – will apply the new nine month requirement. Previously, people needed to be in France for at least six months out of the year to qualify.

If you receive this benefit already, you will probably get a letter in the mail in the near future informing you of the change – this is a form letter and does not necessarily mean that your benefits will change.

If you are already a recipient – and you live in France for at least nine months out of the year – then you do not need to worry about your access to the ASPA changing.

If you want to access this benefit, it is available to certain foreigners, even though it is intended to help elderly (over 65) French citizens with low state pensions.

It is only available to foreigners who have been living legally in France for at least 10 years, and starting in 2025 you will need to spend nine out of 12 months a year in France. You can find more information at THIS French government website.

Otherwise, prestations familiales, or family benefits will be affected by the new nine month residency rule. These are available to foreigners with valid residency cards, as long as their children also live in France.

This includes the family allowance (given out by CAF), which is available for families on low incomes with more than two children, as well as the ‘Prime à la Naissance’, which is a means-tested one-off allowance paid in the seventh month of pregnancy to effectively help with the start-up costs of becoming a parent, will also be affected by the new nine month residency rule. 

READ MORE: France’s family benefit system explained

If you receive these benefits already, then you will likely receive a letter explaining the changes shortly.

And finally – the RSA, which is the top-up benefit for people with little to no income, was already held to the nine month standard, so there will be no residency-related changes.

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