What to Expect French Healthcare in 2022

At the same time, online health services guarantee increasingly personalized healthcare. However, to make e-health available for all, increasing digital literacy will be crucial. Currently, 17% of the French population have insufficient digital skills, compared to only 10% of the British population. 

The French healthcare system is financed by a social security system, which holds a deficit that amounted to 1.7% of GDP in 2020. In 2024, this deficit is estimated to represent more than €15 billion. Today, innovative drugs allow patients to "live with" certain diseases that were, until recently, considered incurable. Yet many of these drugs are expensive, and their arrival on the market raises concerns about the French government’s ability to regulate prices while guaranteeing access to all patients. These concerns appear to be well-founded, since France currently ranks 21^st in Europe for the average time to market new products, placing it well behind its German (1^st), British (7^th) and Italian (10th) neighbors. The CSIS (the Strategic Council on Health Industries) 2021 and the Plan innovation santé 2030 (the 2030 Health Innovation Plan) have been welcomed by healthcare stakeholders as a sign of the government's determination to make this issue a strategic priority. 

A new governance for the French healthcare system

Despite a trend towards decentralization, the central government still makes most of the decisions in France. However, state ministries are often out of step with specific regional needs. While regional health agencies in France play a role in steering the health system, they are not yet sufficiently involved in defining and directing public health policies. 

States like Quebec have gone a step further by implementing the principle of "population responsibility". This aims to make public and private actors responsible for improving the health and well-being of their population. In France, this approach could provide a solution to the fragmentation of the healthcare system. It makes it possible for healthcare professionals to better define and communicate their care pathways. 

Preventative politics for Mental Health and Aging

Given its low investments in preventative healthcare, it is likely that France will accumulate risk factors in comparison to other OECD countries. Two priority areas stand out in this regard: mental health and aging. 

The Covid-19 crisis has had major consequences for mental health in France, as depressive disorders doubled between September and November 2020. Even though psychiatry represents the largest expenditure for the French health insurance system, patients are still poorly diagnosed and often treated too late. General practitioners should be more involved in the early detection of psychological disorders. Indeed, 60% of consultations for psychological disorders are done in primary care medicine. To that end, better training is needed for general practitioners.

Regarding the second priority, aging, French society faces several challenges. France has experienced a sharp increase in its aging population over the last thirty years. Today, 20% of the French population is over 65 years old. Nearly 70% of the over 85 year olds suffer from at least one chronic disease. Although life expectancy in good health has increased over the last decade, the figures are not distributed evenly. The loss of autonomy and life expectancy at birth without disability remains lower in France than the European average. In order to promote "active aging", the French healthcare system must adapt to better meet the needs of seniors. This could be realised by, for instance, encouraging the development of mechanisms that allow seniors to maintain independence, or through targeted prevention policies.

In sum, the Covid-19 crisis has revealed profound weaknesses within the French healthcare system. Yet it has also provided new and unique opportunities to invest in innovative technologies that will prioritise patient-doctor relationships, and make healthcare more accessible. Going forward, the government should give precedence to implementing care indicators, digitizing health services, restructuring the governance of healthcare, and investing in long-term preventative policies. Making healthcare a strategic priority will be a determining factor of both the upcoming elections in April 2022, and the subsequent success of the new government. 

Co-authored with Laure Mourgue d’Algue, Assistant policy officer.