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Sustaining Universal Health Coverage in France: A Perpetual Challenge

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Listed:
  • Helene Barroy
  • Zeynep Or
  • Ankit Kumar
  • David Bernstein

Abstract

While universal health coverage (UHC) offers a powerful goal for a nation, all countries-irrespective of income are struggling with achieving or sustaining UHC. France is a high-income country where HC is in effect universal. Health-related costs are covered by a mix of mandatory social health insurance (SHI) and private complementary schemes, while benefit packages are comprehensive, uniform, and of good quality. France provides some of the highest financial protection among countries in the Organization for Economic Co-operation and Development (OECD). Still, under pressure to sustain UHC without compromising equity of access, the system has been fine-tuned continually since inception. Much can be learned from France's experience in its reforms toward better fiscal sustainability, equity, and efficiency. The main purpose of the study is to assess major challenges that France has faced for sustaining UHC, and to share its experiences and lessons in addressing system bottlenecks to benefit less developed countries as they embark on the path to UHC.

Suggested Citation

  • Helene Barroy & Zeynep Or & Ankit Kumar & David Bernstein, 2014. "Sustaining Universal Health Coverage in France: A Perpetual Challenge," Health, Nutrition and Population (HNP) Discussion Paper Series 91323, The World Bank.
    • Handle: RePEc:wbk:hnpdps:91323
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    References listed on IDEAS

    as
    1. Or, Zeynep & Cases, Chantal & Lisac, Melanie & Vrangbæk, Karsten & Winblad, Ulrika & Bevan, Gwyn, 2010. "Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems," Health Economics, Policy and Law, Cambridge University Press, vol. 5(3), pages 269-293, July.
    2. repec:hal:pseose:halshs-01053340 is not listed on IDEAS
    3. Zeynep Or & Julia Bonastre & Florence Journeau & Clément Nestrigue, 2013. "Activité, productivité et qualité des soins des hôpitaux avant et après la T2A," Working Papers DT56, IRDES institut for research and information in health economics, revised Apr 2013.
    4. Marion Devaux & Michael de Looper, 2012. "Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009," OECD Health Working Papers 58, OECD Publishing.
    5. repec:dau:papers:123456789/13209 is not listed on IDEAS
    6. Sophie Guthmuller & Jérôme Wittwer, 2012. "L’effet de la Couverture maladie universelle complémentaire (CMU-C) sur le nombre de visites chez le médecin : une analyse par régression sur discontinuités," Post-Print hal-01686606, HAL.
    7. Kunst, Anton E. & Groenhof, Feikje & Mackenbach, Johan P., 1998. "Mortality by occupational class among men 30-64Â years in 11 European countries," Social Science & Medicine, Elsevier, vol. 46(11), pages 1459-1476, January.
    8. Martine M. Bellanger & Philippe R. Mossé, 2005. "The search for the Holy Grail: combining decentralised planning and contracting mechanisms in the French health care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 119-132, September.
    9. Culyer, A. J. & Wagstaff, Adam, 1993. "Equity and equality in health and health care," Journal of Health Economics, Elsevier, vol. 12(4), pages 431-457, December.
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    Cited by:

    1. Mohajan, Haradhan, 2016. "An Analysis of Knowledge Management for the Development of Global Health," MPRA Paper 82959, University Library of Munich, Germany, revised 16 Aug 2016.

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