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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

Explained: What are ‘French values’?

Part of France's new immigration law is a requirement for foreigners living in France to sign a contract saying that they respect 'French values' - but what actually are these values?

Explained: What are 'French values'?

France’s new immigration law, passed in January after a tumultuous political journey, includes several big changes for foreigners living in France or those hoping to move here, including French language tests.

Also included in the text is a Contrat d’engagement au respect des principes de la République (contract of engagement to respect the principles of the French republic). This is a new requirement that everyone applying for a French residency card or visa – including people renewing residency cards – will have to sign this contract agreeing to ‘respect the principles of the French republic’.

You can read full details of how this will work in practice and which groups are affected HERE.

Because this requirement has not yet come into force we don’t know the exact wording of the contract that people will be asked to sign.

But there is a similar requirement already for certain groups of people applying for residency, while people applying for French citizenship are also asked to demonstrate that they understand and adhere to the values of France.

So what are the values of France?

Article 1 of the French Constitution defines the French republic as “indivisible, secular, democratic and social” and adds that these values constitute the 4 pillars of the republic. 

The website of the president’s Elysée Palace defines the 4 values like this:

Indivisible – that no individual or group is exempt from the laws of the republic or is allowed to exercise sovereignty over the rest of the population.

They add that the principle of unity guarantees that laws, rights and duties are the same throughout mainland France and the overseas territories (although in fact there are several small differences to laws between France and some of its overseas territories).

The Elysée adds that being ‘indivisible’ is why France only has one officially recognised language – French. Although regional languages such as Breton and Occitan have legal recognition, they are not official languages of France.

Secular – French laws on laïcité – which first came into force in 1905 – state that all residents of France are entitled to their religious beliefs, but that religion plays no part in the state itself.

It is this principle that explains why, for example, Christmas cribs are not allowed in town halls while state employees are banned from wearing religious symbols, like the kippah or the hijab headscarf.

READ ALSO What does laïcité really mean in France? 

Although the basic principle of laïcité is a straightforward one, the details remain contentious and even many French people either don’t understand them or pretend not to understand them for political reasons.

Meanwhile topics that relate in some way to laïcité – such as the wearing of the full-body burkini swimsuit often favoured by Muslim women in public swimming pools – tend to be hot-button issues

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The Elysée adds: “Secularism is one of our most precious values, the keystone of a harmonious society, the cement of a united France.” 

Democratic – The idea of a democratic political system is hardly unique in Europe, but the French definition includes the line “The democratic nature of the Republic implies respect for fundamental freedoms”.

These are often defined as supporting concepts such as freedom of expression, freedom of religious belief and freedom to love (for example, through same-sex marriage).

“Regardless of their personal history, level of education, wealth or gender, all citizens have the same value in the eyes of the State,” says the Elysée. A nice idea that we can all get behind, but it’s not too hard to find examples of where that isn’t actually true in daily life in France.

Social – this sounds like a bit of a vague term, but the Elysée insists “the social character of the Republic stems from its commitment to equality”.

So you would be expected to adhere to values such as equality between men and women, social cohesion and equality of opportunity in order to demonstrate your commitment to the principles of the republic.

“To ensure that this equality of rights is full and complete, alive and concrete, the State also works to ensure equality of opportunity by providing special support for disadvantaged or vulnerable citizens, and by encouraging social cohesion in the fields of education, housing, employment and health,” the Elysée adds.

Again, this is perhaps more of a goal than a daily reality, but support for disadvantaged or vulnerable people – for example through sickness benefits or state-funded healthcare – can therefore be seen as a ‘French value’.

How do you demonstrate these?

The new Republican integration contract will be a form of words that applicants must sign when completing an application for a residency permit – not too dissimilar to accepting the terms and conditions when making an online purchase.

If you want to become French the requirement is a little tougher and you will need to demonstrate that you both understand and adhere to those values.

Unlike some countries France doesn’t have a written citizenship test, instead it’s an in-person interview where you have to demonstrate; your knowledge of France and its culture; your understanding of French values; your agreement and adherence to those values and principles.

People who have been through the citizenship interview often report seemingly strange or random questions such as ‘Do you and your husband share household chores equally’ or ‘Would you accept having a male gynaecologist’ – although these questions can seem bizarre, they make more sense once you understand the values they are trying to test.

READ ALSO What might you be asked in the French citizenship interview

Because laïcité is both a particularly French concept and one widely misunderstood by foreigners, it almost always comes up during citizenship interviews.

It’s important to point out that adhering to these values do not mean that you can’t criticise the government, its policies or even go on a protest about a particular issue – after all, what is more French than protesting?

But if you want to gain French citizenship, you will need to demonstrate that you agree with the ‘four pillars’ as outlined above. 

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