French Social Security System
According to the World Economic Forum, France spends one third of GDP on state benefits and the Sécurité sociale system, which is divided into four different branches:
Retirement and Old Age
Work and Accidents
There are 4 different regimes in France for the Social Security system (and have been since the 1940s). They are:
Until 1791, when the Allard Decree was passed, there were private organisations that provided some sort of assistance to the members that belonged to it. But, in 1791, this rather unorganised system was transformed by the creation of Sociétés de secours mutuelles, providing assistance to those that were in need. This was the beginning of the mutuelles, top-up insurances that most people have when resident in France today. But, those early mutuelles did not just provide healthcare cost insurance, they also even provided loans to people that were in need, and that wouldn't have qualified or got a loan from a bank in the 18th and 19th centuries.
Like in most countries, the French Social Security system was progressively set up throughout the 19th and early 20th centuries, to become what it is today.
Free medical assistance was implemented in the law of 15th July 1893 (la loi sur l'Assistance médicale gratuite (AMG)). It allowed the poor, the old and those without any resources to benefit free of charge from medical assistance and healthcare. Childcare programmes were begun in 1904 and the elderly and disabled were provided for in the law of 14th July 1905. It became an obligation for employers to take out insurance in the event of an employee being injured after the passing of the law of 9th April 1898.
The modern social security system in France came into being under the Constitution of the 4th Republic, passed (by referendum), in 1946. General de Gaulle's government, by ordonnance dated 4th October 1945, put the wheels in motion for the French Social Security system to be set up. However, not only did it exist really before, but it was also surprisingly added to by the Vichy Regime in place while France was occupied by Nazi Germany. But, in 1946, what was new was that the State had an obligation to provide assistance to those that were vulnerable, children and the old. Gradually over the following decades those that had been excluded or that had particular regimes (farmers and agricultural workers, sailors, government employees...) were brought into the social security system. Government employees gained access to the social security system in 1947. It only became mandatory in 1961 for farmers to have health cover, for example.
Universal Healthcare was obtained in France after the law of 26th July 1999, coming into effect in 2000. This provides for two basic rights in France:
Any resident in the country (who is considered to be settled in the country on a basis deemed to be regular, and stable) must be provided with healthcare.
If the resources of the person do not allow them to have access to medical care, then the fee will be waived completely.
The financing of the Social Security in France comes from the following areas:
Employee and employer contributions (64%)
The CSG (Contribution sociale généralisée, created in 1990, accounting for 16.2%)
Taxes and other social contributions (12.5)
Net transfers (4.6%)
State contributions (1.7%)
Other sources (1%)
The latest figures available from the Ministry of the Economy state that the total expenditure of the French Social Security system stood at 474.5 billion euros (2014), divided up into the following areas:
Retirement and Old Age - 217.2 billion euros
Health - 183.9 billion euros
Family - 39.8 billion euros
Work and Accidents -10.7 billion euros.
The deficit of the Social Security system in France stood at 9.9 billion euros in 2014. Health had a deficit of 6.6 billion alone and stood for the largest proportion of the total deficit.
In 2015, an objective was passed to reduce that deficit to 7.9 billion euros. But, since then, Covid has happened.
Estimates show that at the present time the Social Security system in France may now have a record deficit of 72 billion euros, or 3.3% of GDP.