Is French health care public or private? Let's be clear!

Imagine being resident in France, having regular French health insurance and go to your doctor. At the end of the visit, the doctor might tell you: "Please, it's 30-35 euros! Paper or cash?". As Italians used to our health system, you could twist your nose and I understand it! Why pay out of your own pocket a visit to the doctor? Is French health really public or all private? What are the taxes we pay monthly to make the public sector survive? All questions absolutely lawful, but to which you can answer learning about the French health system.

Why are health benefits paid?

The French health system is not exactly like the Italian one, or at least not always! For a medical examination you may find yourself faced with two cases:

1. pay nothing, just like in Italy;
2. advance the money, which will then be refunded.

In the first case, which generally occurs in hospitals, pharmacies or so-called Centres de Santé, the policy of tiers payant, literally "payment for third parties". The health service will pay the specialist directly, without the taxpayer’s obligation to anticipate health costs. Only a few euro will be charged to the patient, for example, with Moderators and franchise tickets, which will be directly scaled by a subsequent refund.

In the second case, the taxpayer will actually have to anticipate expenses, but will get a refund in a short time. For most health services, reimbursement by the national health service will be 60-70% (medical visits, X-rays, biological analyses etc.)

And the remaining 30-40%? Is it the taxpayer?

Here comes the mutuals, supplementary private health insurance:

• usually it is not mandatory to have it, but almost everyone has it, especially families;
• the cost is variable as needed. The more expensive the mutuals, the more attractive reimbursements will be;
• the mutuals However, it is mandatory for employees of private companies, who often offer high quality insurance, with total reimbursements on most services. With a single supplementary insurance, only the employee or his whole family can be insured. A large part of the membership is taken over by the company, So only a small part of the expenses are raised by the employee's salary. For those who face major health expenses every month, this small "contribution" is very beneficial.

The supplementary insurance, within a short time, then intervenes to refund everything else... or almost! The precise amount of the refund depends on the type of mutuals and especially by the type of Convention to which the French doctor adheres.

So what does doctor mean? conventionné secteur 1, 2, 3?

Here comes the main difference between Italian and French healthcare systems: instead of public and private health, in France it is more correct to speak of "Conventions".

If a specialist or medical centre is conventionnés secteur 1, means that they comply with the standard tariffs laid down by Social sécurité. When the latter reimburses 70%, for example, of a medical examination, it means 70% of a medical examination agreed with sector 1. In 2025, the standard cost of a basic doctor agreed with Sector 1 is 35 euros.

If they are conventionnés secteur 2, means that the figures are slightly higher than those expected by the Social sécurité, but always "reasonable". For example, a doctor with an agreement with sector 2 will cost 45 euros instead of conventional 35 euros. This means that he practices the so-called dépassement d’honoraires. The Social security It will, however, undertake to reimburse the basic percentage, while the dépassement d’honoraires it will be refunded, where appropriate, by supplementary insurance. Before choosing a specialist, I recommend you always consult its rates, to avoid anticipating too high figures.

The doctors of the secteur 3 Instead, they are the equivalent of private doctors in Italy. They are fully free, not in line with those established by the national health service, and with less attractive reimbursements for patients. It remains a relatively small sector in France, since only a small portion of the population can afford such costly health costs.

Why is it important to clarify French health?

Because, as often happens, misinformation is too much. Some people believe that it is French health care that is public thinking of the "Italian model", who consider it private only because they find themselves anticipating expenses. Who, without any critical sense, compares it with the Italian system, judged better in every respect.

If French health, despite its problems, remains stable and efficient, it is clear that this public-private system works. At least Paris you can book a specialist visit in a few days and without necessarily in debt. The same, of course, is not true of the small French towns of the countryside... but not even of most of the big Italian cities! According to friends and relatives, those with serious illnesses can spend more than 1000 euros a month on medicines and visits, because Italian public health is saturated and the private sector is the only way to be treated without waiting months in months. The same cannot be said of France, at least not Paris, after decades of direct experience, without pink filters or preconceptions.

When we compare different countries, we try not to start immediately on the defensive. Instead of seeing it as a free criticism, let us take it as an opportunity to grow and reflect on the strengths and weaknesses of our country of origin.