Guest Post

The World Health Organization released a Healthcare Performance document in 2000 detailing a methodology by which to compare Healthcare Quality across 191 different countries using similar metrics to give a comprehensive outline of which countries healthcare was the most efficient, highest quality, and least uncertain for patients.

According to the WHO, France tops the list. Apparently black and white silent films about people smoking in cafes have led to quality healthcare?

Social Security?

In America, we know Social Security as a system where we pay the government over the course of our lives and then when we are older (65+) we collect a check from the government to help pay for life’s needs when we are passed our working age and entering into our golden years. If we get hurt, we can file for disability and if we are fired we can file for unemployment. In France, it’s a bit different.

French Social Security asks very similar things from the citizen. Who are you?  Where are you from? How old are you? Etc., but with that information the French government provides a sense of security for the now. French citizens pay into a mandatory healthcare budget that, while being the product of an entire ministry, is often surpassed by actual healthcare consumption. French healthcare spending accounts for around 11% of its GDP which, to many economists, is quite high, but if those economists live in America (17.7%) they may want to spend their time working on something more useful. The French Social Security system was enacted at the end of WWII to hopefully service those who would be needing care in the coming years, who will assuredly not be able to afford it due to the crisis of economy having your capital seized by Hitler ensures. According to WHO in the year 2000, it worked.

Social Security in France takes many of the benefits afforded to American Social Security recipients and adds to them the certainty that if things go wrong and their health is concerned, they will be cared for and they won’t have to be readmitted when they see the bill. French Citizens are issued what is called a “Carte Vitale”, like a “credit card” for healthcare. The second generation cards are supposed to carry relevant health history and documents on top of the first generations simple identifiers that allowed providers to treat patients knowing they were French citizens covered by the system. The system is paid for mostly through payroll and income taxes and the “budget” is not a hard number, it is more a goal that the country shoots for as far as government expenditure on healthcare.


In France, Social Security may not cover everything, and in order to fill the gaps, French citizens may purchase private insurance of their choosing. Social Security is universally recognized because the French government regulates the healthcare economy fairly heavily. Things like rates for service, copays, and pharmacy costs are all set by the Ministry of Health. Only 1/3 of hospitals are privately owned, leaving the vast majority of citizens with public hospitals as their only choice, however this does not seem to bother the French as much as private healthcare fans in the US might think.  In France, the government covers most costs associated with obtaining a medical degree, doctors do not need to pay for malpractice insurance and these things all make the cost of actually providing care much lower than in the US. Healthcare workers cannot expect the same luxurious paychecks as American doctors though and complaints of low wages and long hours are frequent amongst France’s Healthcare workers. Many Specialists are Private but in France, there is no need for a recommendation to see one, if you do have a recommendation, you get a pretty sweet discount though.

How Did France Snag the #1 Spot?

On top of the factors stated above, there are many other reasons France is so highly recognized for its healthcare system.

Patients with chronic illnesses pay less than those with less serious ailments, cancer patients are covered for just about any kind of care they look to receive, including some homeopathic remedies like acupuncture. Preventative care is a high priority so French citizens are encouraged to get regular checkups, meaning less unnecessary ER visits. There are 3.4 doctors for every 1000 French citizens, which might not sound like a lot, but here in America, we only have 2.6. On average, healthcare costs the French $4000 per citizen, per year, which some say is expensive but yet again, Americans pay a substantial amount more with each citizen, on average spending $9000 a year. All of these factors are taken into account with the WHO’s analysis and are certainly a part of why French citizens feel far less uncertainty about their future regarding health.

So, as Americans, we have some work to do in updating our healthcare system. Will France be our guide?

About the Author

Hello, you can call me Suede. I am a Millennial living in Southern California and over the course of my short life I’ve worked in more industries than many will ever experience, experimented with psychoactive substances and explored the inner workings of the human mind to find the underlying truths that we all live with. My journey has led me all over the United States and a few places outside it in order to understand what makes a life worth living. I am an entrepreneur, an autodidact, and a creator. I am Suede, nice to meet you.

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