(Remember. in France "Securite Sociale" does not mean "retirement pension" like in the US. it means the whole social system of Health, Family benefits and retirement pensions)
As a matter of principle, everyone working in France must contribute to the French Social Security system and everyone (French or not, working or not, unemployed, child or retired, legal or illegal immigrant) is entitled to benefit from it. There are few (recent) exceptions to this principle but it is maintained (with CMU. Couverture Maladie Universelle which means "health plan for everybody" only 0,1% are not covered). The system is rather complex and considered bureaucratic when it comes to create a new company (but not for the patients).
The system is threefold. Health, Family and Retirement. each of them has different structures and financing ; they are managed by the "partenaires sociaux " (see the meaning of this important concept) on a joint and equal basis, the s-State being only the "referee" ; each of them is financially autonomous (no taxpayer's money - except to subsidize CMU- but contributions by employers and employees to make it balanced). to understand it better. see the anatomy of a paycheck ;
The Health system (Assurance Maladie ) is based on the concept of providing a large amount of help for any medical need, and total help when it is serious. on the basis of a standard cost, medical care (doctors appointments and visits, dental care, etc..) is reimbursed around 80%, medicine from 80% when corresponding to a real medical need to 40% for less needed and of course 0% for others ; standard cost for a doctor is 22 Euros (sometimes, they can charge 30 Euros or more: dépassement d'honoraires ) ; serious illnesses, including those due to old age, are covered 100%. Practically speaking each person has a chip card (Carte Vitale ) which is read by the doctor's or pharmacist's terminal and a 13-digit "numéro de Sécurité Sociale ".
The health system is a key-element of the French national identity. the "three best symbols of the French nation" are the flag, the health system and the Marseillaise (source. survey TNS-Sofres March 2005)
Contrary to what one could expect from a large, state-owned and centralized organization, the system is very efficient. the administrative cost of the health system is around 4,5% (for US private insurance companies. 10 to 13%) and 1,2% for the retirement system (vs. around 10% for most pension funds). The health system reimburses very quickly (after four days).
The Social Security structure is managed on a paritary basis. each regional organization (Caisse ) is managed by a board composed 50/50 of representatives of labor unions on one side, employers associations on the other side, with the State playing the role of a referee ; the financial contribution of the patient is very limited and most of the funding is public. The state is considered responsible of its good functioning, but it is not accurate to call it a "socialized system". See why.
The Family system (Allocations Familiales ) is a financial help
to all families (whatever their income) plus various services such as day-care or vacation centers (according to income) ; when a family is expecting a child, it gets approximately 2,000 Euros in three installments (the first two of them corresponding to a mandatory medical visit, the third to the birth) ; then the family receives a monthly allowance till the child is 20 (for two children or more, around 100 Euros/month/child). see detailed numbers ; t his is not the only allocation and this organization ("Caisse d'Allocations Familiales") yearly distributes enormous allocations (Euros 72 billion in 2009) to millions of families. for families of two children or more, to help people to keep their old parents in their home, for children with a handicap, and many others… (See details )
The Retirement system (Assurance Vieillesse ) provides a minimal pension (in the range of 750 Euros/month) to any person who has worked 40 years. click here for more
What to do if you are sick?
If it's minor. ask your pharmacien (pharmacist). his job is to help people and give advice
If it's more serious. you can :
see any French doctor. unless he/she is one of these doctors specialized in US patients because he/she speaks (or pretends to speak) English, he will charge you the normal French price and the only diference with French patients is that you won't be reimbursed of it
or. Call SOS Medecins (08 20 33 24 24). you have to descrive your problem (in French), they come within 2 or 3 hours for a fee of around 100 Euros and provide a very good serviceIn case of emergency. you can.
- go to the Urgences (Emergency) of the nearby hospital
or. call the SAMU (telephone. 15 ) who comes very quickly and charges nothing
Emergency. about the SAMU.
In France, since 1968, the entire country is covered by a (public) organization called SAMU (coordinating regionally the emergency mobile services of the local hospitals, called SMUR). SAMU is called by dialing 15 (and "SAMU 38" is the name of the service for the "departement" #38). They operate with ambulances and helicopters. Each crew is composed of a driver, a physician (emergency or resuscitator) and a nurse, with the equipement allowing a medical intervention on the spot. The first difference with the US is that the system is homogeneous and you get the same service all over the country, from Paris to the most remote village. But the major difference, which makes the efficiency of the system, is that, contrary to the US, the crew includes a physician and the medical treatment does have to wait until the patient reaches the hospital. Figures disclosed in the US in 2015 showed that the mortality after a heart attack or a stroke in much higher in the US, partly due to the organization of the emergency mobile system.
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