Expats moving to France have always had plenty of reasons to be proud of the lifestyle in their new country of residence, but now they have an extra reason to be charmed by 'la vie en France'. France has taken the top spot in the healthcare category of the annual International Living Magazine's annual Global Retirement Index Report.
The health care category considers the cost and quality of the service available. It also considers the number of patients per doctor, the number of beds per 1,000 people, life expectancy and public health expenditure as percentage of a country's GDP. France scored an impressive 97 out of 100 in the health care category. Not far behind, Spain scored 91 out of 100 in the same category.
France also scored well other categories, including Entertainment and Amenities (100/100), Retirement Infrastructure (87/100) and Special Benefits (84/100). The Special Benefits category grades the country on pensioner discounts on things such as health care, public transport and entertainment, as well as property rights for foreign nationals and property tax rates.
Like England, France has both a public health system and a private-sector option, with the public sector health care system being available to those who pay into France's Social Security System (Sécurité Sociale). The French public health system has a widely recognised reputation for quality of care and pays for the majority of medical costs (around 70% in many cases). Private medical insurance is mandatory for non-E.U. citizens moving to France, with varying levels of cover.
The public healthcare facilities in France are comprehensive, of an impeccably high standard and, most importantly, are accessible, with a general absence of the painfully long waiting lists that can occur in destinations like the UK and Canada. As a result, expats will find they have the luxury of choice when choosing a specialist or doctor in France.
The public health system, Sécurité Sociale, is funded by tax contributions, and expats currently working in France and/or paying French tax are eligible for cover. Additionally, expats who have hit retirement age in their home country are also able to access the service - all that is required is registration at a local social security office.
When moving to France from the UK, expats must register with one of the state health insurance companies (Caisse Primaire d’Assurance Maladie - CPAM). Once registered, you will be issued with a Carte Vitale, a plastic card fitted with a microchip containing your social security details similar to a chip and pin bankcard. In the vast majority of cases, this will be presented at the time of the medical consultation and will facilitate the reimbursement of any medical fees that are charged on the day of the doctor or hospital visit.
Highly recommended is the French welfare program Couverture Maladie Universelle, which reimburses medical expenses through social security. It's important to note that cover isn't absolute in France.
As such, what has subsequently emerged is the orthodoxy of taking out extra private insurance to provide suitable cover that the government doesn't cater for. Again, in most cases, where treatment is required, costs will be reimbursed.
The other option available to British expats is private healthcare, especially for those who are unsure about how long they will be working and living abroad. As a starting point, professionals are asked to consult their employers about what options they have within the company. If an organisation is known for having a history of distributing employees all around the world, it is very likely that it will have some sort of policy in place. As with anything, it is essential to ascertain how comprehensive such a scheme is to ensure you can make efforts to put yourself in a comfortable position.
All in all, despite having to pay upfront for costs (which are reimbursed), France's healthcare system is commendable. Overall life expectancy from birth for France is 85 years for women and 78 years for men, citizens have free reign over which doctors and experts they want to see, the mixture of public and private care coexists very well, and everyone, through a compulsory scheme, has access to care, regardless of their financial predicament.
In 2008, the BBC ran a story with the headline "Do the French do it better?" In short, the piece compared the British healthcare system to the French equivalent, with the author concluding that the latter is better. Why then? The straightforward answer is the French government spends more and has done so consistently for a good many years (in France, health spending per person is £2,250; in the UK it is £1,799).
The UK however, in terms of NHS budget, has had governments which have historically been rather modest with allocating funding to healthcare, a surprise no doubt given the country's association with ushering in the concept of a modern welfare state.
For example, in 1948, the year that saw the National Health Service Act, National Assistance Act and National Insurance Act come into force, the NHS budget was only £280 million. Now while this may seem like a large sum for the period, it was only 3.1 per cent of the UK's national income.
That's not to say the UK hasn't made advances in the subsequent 60-plus years, as the article alluded to. As of 2008, the budget was £105 billion, which translates into a much improved 7.6 per cent of the UK's GDP. It's merely a matter of catching up before the UK can, it is sad to say, equal the French.
This news bodes well for British expats, for France is, it comes as no surprise, one of the healthiest countries in the world. So much so that in 2010, the World Health Organisation, in its first ever analysis of the world's health systems (191 in total), found that France delivered the "best overall healthcare".
Now while this is reassuring, how exactly does it benefit foreigners who are moving to France, a country famed for its enviable way of life? Simply put, expats will get the same treatment as native French citizens, although, that said, people need to be conscious of the fact that there is no universal notion of a "perfect system" of healthcare. Consequently, what might be the norm in the UK in terms of provision might be atypical in France.
The underpinning architecture that governs France's healthcare is a social insurance system, which covers all residents. This is funded by compulsory social health insurance contributions, which is mandatory for all employers and employees to make. It isn't possible, for example, to opt out. Roughly speaking, expats will have between six to seven per cent of their salary allocated to healthcare.
France's healthcare system is unique in so many ways and follows its own path. It might as well, for the statistics speak for themselves. British expats can be confident that, along with great coffee and a relaxed atmosphere, the last thing they will need to worry about is a lack of security over welfare.
A balmy climate, improved work-life balance, better career prospects – there are numerous factors that play their part in convincing expats to move overseas and begin a new life abroad. But decent healthcare provision does not always necessarily come top of the list. After all, health is something we all take for granted at times. It doesn't seem to matter until... well, until it really does.
France has long been esteemed amongst the expat community for its excellent healthcare system and a recent study from the World Health Organization (WHO) has solidified this reputation. The research has ranked France as the number one country in the world for expat healthcare, thanks to a comprehensive combination of private and publicly-funded services that provide excellent, efficient and inexpensive medical cover for residents. Additionally, just last year, International Living magazine awarded the French healthcare system a huge 97 out of 100 points on the publication's annual Global Retirement Index with the magazine concluding, "France provides the best health care system in the world."
If you are considering retiring and moving to France, Cadogan Tate can help with your international removal.
Information correct at time of publication