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Three-quarters of the French population of 58 million live in cities and towns. The country is crossed with modern highways and rail systems, making it possible for patients to have easy access to medical facilities. The health care system is primarily socialized, but the nature of the care provided remains uniquely French. The populace had a great deal to say about how they wanted their health care delivered. In France, there is no discrimination against patients because of their social level. Patients are also at liberty to select the type of care they receive. Provided technical requirements are met, all physicians can diagnose and treat patients no matter what their medical designation, e.g., internist, generalist, pediatrician, neurologist, etc.
All individuals who reside in France, including foreign workers, the unemployed, and students, have to apply for social insurance. This is a nationwide insurance program that is run by national trade unions and is paid for by employers (66%) and the insured (33%).1 The insurance covers medical complications resulting from accident and disease, including coverage for the entire family. It also covers medical care, diagnostic investigations, drugs, and even some transportation costs involved with medical visits. Surgical care is covered 100%. Physicians receive full payment from patients at the time of service, thus eliminating billing problems except in cases of patients with diseases that receive total coverage. Thirty diseases are characterized as chronic and incapacitating and are covered fully, such as tuberculosis, poliomyelitis, psychosis, and severe mental retardation. Although epilepsy is not included on the list, epilepsy with associated handicaps, epilepsy with encephalopathy, and some pharmacoresistant epilepsies with cognitive impairments are covered in full. Patients with diseases that are not fully covered must pay 20% of the costs for care and treatment. Patients also pay 15 to 35% of the expenses …
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