France cuts Britons' health care -- What's the story?

This is a call to British and other European expatriates in France. Over the past week, there has been a flurry of alarming reports about British residents losing coverage under the French health care system.

It turns out that the story springs from a new law that bars Europeans from joining the French state system if they are not working, not retired and not covered by a temporary home-based arrangement. Barring some exceptions, they must take out private insurance. Here's our article today.

The change was well known, but it appears that some regional authorities may be acting with Sarkozy-style rigour and cancelling Cartes Vitales (the entitlement card) held by Britons already in the French system. The Paris Social Security ministry tells us that this is impossible since the change applies only to new applicants.

The UK authorities were unaware of a problem. Despite the rumours of trouble, we only found one case of an existing Carte Vitale being revoked. It would be useful to know if there are other cases and also how non-working expats are affected by exclusion from the French universal health cover scheme. Let's hear if the horror stories are true.

 

Comments

[alan morgan]

Between the official E cover, provided by the uk authorities when you first arrive in France, and the age of retirement ( 60 ) there is a grey area for those UK nationals, permanently resident in France.
When you arrive the E106 allows you to join the CPAM system for a limited period of time only. When that expires you have to reapply under the law of right of residence. Various documents have to be produce to justify your request: namely passport, evidence of payment of tax, electricity bill confirming permanent residence etc.
Because there is fraud/ abuse of the system the French authorities have regular checks to make certain you continue to conform with the regulations.
Many people have abused their travel cover, not declared their income or failed to pay social contributions or URSSAF. It is not because you are British, nor because you live in France that you encounter problems with the French Bureaucracy . The reason lies much closer to home.

[azloon]

what's the deal here? a british citizen, resident of france, or travelling (or working), can get french health care?

who pays for it?

does the uk reimburse france?

what about french health care for other europeans, from eeu countries, in france?

what if you're japanese, or american, and get sick in france? if you go to an hospital, will you receive treatment? must you pay in advance or are you billed at the going rate? is anyone turned away from required treatment?

i am curious about this.

there is a funny section in 'my year in merde' in which the author describes a visit to a french doctor. he makes the doctor experience sound quite acceptable (prescription meds are another matter), abeit it seems the 'free ride' encourages "professional patients" (as it does in the u.s. medicare system, and treatment of veterans in fee-free hospitals).

CB, i hope you are not in jeopardy. i would hate to think of you trying to relax in the cevennes hills worried about your coverage.

i'm serious.

on medicare, i am, yours truly ..........

[John Gregory Flinn]

I have'nt had any problems but then I'm retired.
However it has occurred to me what happens to my wife and children if I die in the foreseeable future? Might these rules apply to them (or her), because my wife is some way from British retirement age and she is not working?
Perhaps some assurance, or otherwise can be obtained on this point.

Reading the article it is clear that France (and maybe others) are waking up to the possibility of uninsured access to their CPAM, and taking steps to curb abuses of it. (However some Insurance is already advisable - 'Mutuelle' - to cover the parts not free in France.)
Presumeably it already applies to non-EU citizens.
Whereas the NHS in Britain is replete with stories about how it's boast to be 'free at the point of use' is abused by health tourists from anywhere.
I believe The Republic of Ireland has recently held a referendum preventing pregnant non-europeans arriving to have their babies there, and subsequently being able to claim Irish citizenship.

[Jorg Andersen]

French health care is about the best in Europe if not the world. It makes sense that you can't just turn up from Britain -- or Romania or Malta or wherever -- and help yourself to a service that the French people pay for with very high taxes.

[Peter Bartleson]

You have to pick your way around the French bureaucracy. But you get there in the end. They are not throwing out Brits. That's media hype.

[Joan B]

Glad to see you have brought some calm to this, Charles B. It's amazing how one stupid newspaper article can send everyone into panic. Isn't the Sunday Times the same as The Times ? They should be ashamed. The CPAM takes good care of us here. We have been here seven years and have never had a problem, but we've got a mutuelle top-up as well.

[Ros]

If one reads the "Have Your Say" which comes after Charles' article in the "paper" Times, someone says
"But I agree with the enforcement. If you haven't paid into the French social security system, why should you feel entitled to claim from it?!
If you have enough money to go and retire in France, it's reasonable to expect that you should cover your medical liabilities too."
Well, I'm not sticking up for the French sec. sociale system but there is some truth in this - it also works both ways, if a French person goes to retire in uk (oh yes this, is quite possible)! he won't automatically have free NHS treatment - but I mmay be wrong.
Azloon:
A japanese or American person who is NOT resident in France will have to pay for all treatments in France be it hospital or not but I can assure you that you would never be refused treatment in any hospital -I'm afraid a private doctor could act differently unless of course you were really ill ,in which case he would send you to hospital & not take a fee himself.(on the other hand he's not going to ask you to pay BEFORE examining you-) But as the private doctor's fees are now only €21, that won't ruin anybody.
When John Gregory Flinn says"(However some Insurance is already advisable - 'Mutuelle' - to cover the parts not free in France.)", he must understand that no treatment whatsoever is FREE in France - one pays and then one is paid back (this can take several weeks at the least) but you are not paid back the whole sum, that is why those who can afford it, pay for a Mutuelle (quite expensive), those who can't? Unfortunately that's just too bad for them so as you see the French system can not in any way be compared to the NHS.

[Pierre]

That's right Ros, on an important topic (perhaps the defining one in the social security debate) the UK is more leftist than France, which might give some bloggers pause to think for a second.

[Daniel Strohl]

Ros,

"those who can't? Unfortunately that's just too bad for them so as you see the French system can not in any way be compared to the NHS".

Ros, I am afraid that this is not quite accurate. There is also the system called "Couverture Maladie Universelle" known under the acronym "CMU" which is reserved for very poor persons unable to pay. For them, everything is free, including for instance dentistery or even spectacles. But I do not know details about this system. But it exists and it is used (and sometimes even misused ...).

[Peter Mason]

Azloon,

The EU operates a scheme whereby nationals from EU countries [plus a few others such as Norway/Switzerland] in another state in the scheme obtain the same basic state healthcare as citizens of that state. Not sure whether their home state pays though. I believe that if the individual relocates to another such state 'permanently' then they have to comply with national rules on eligibility although again EU rules ensure that this is on much the same basis as nationals of the host state.

CB: I'm afraid my first reaction to this story was intense amusement at the likely of the various Mail/Torygraph readers on my daily commute who loudly declaim their intention to retire to France in order to live life as if it were the 50's upon hearing that the healthcare provision might not be there. I suspect the story might be a tad over-egged but at least it gave me a wry smile.

[azloon]

Daniel --

thx for the tip. i will certainly check into CMU if in france for an extended stay.

[Pierre]

The system described by Peter Mason also applies to unemployment cover, which in France is proportional to previous income.

[Daniel Strohl]

Azloon,

As a PhD-Loon, you may have a chance ...

PS : Do you really intent to come to France ? If yes, please let me know.

[Marie]

Not working,no benefits.That the Uk system for French living here,so what the difference?
Fair enough,time the rest of the world stop to think France is a Red Cross base.
I live here for 10 years,and I dont have a vital card (back home) bse I dont pay towards the french system but the Uk system,so that fair enough...Now bse I am still a French citizen I still enjoy the health system but I have to pay myself at first and then get less money back from the French social security.
This is fair....
You should go the US,and come back,then you would tell us thank,even if you would have to pay a bit out of your pocket.:)

[azloon]

Daniel --

i was kidding about CMU (i assume it is "pour indigentes" and i wouldn't qualify without committing fraud).

but i may make a trip to france before too long. and i will let you know if and when i do.

rob

[Ian SISLEY]

My current situation is that I have been a French salaried employee (1998-2006) but that I am now living permanently in France whilst working full time for British companies, mainly overseas (ie. outside EU). My family still live in France, the children go to school here, always have and I still have Vitale cover but the French CPAM would like me to obtain an E106 to keep my dossier in order which the UK NIC are loathe to do. So we have a case of the French being willing but not, apparently, the UK Authorities!

[Daniel Strohl]

Azloon,

I know of course that you were kidding with the CMU ...

French is a complicated language. You said "indigentes" - perfectly correct, but for ladies. Men are "indigents" ... But we have many persons of both genders committing fraud ! In this case, one may call them "faux indigents" (even in the case where we would have a majority of "indigentes").

The adjective "indigent" may also be applied to a reasoning - un raisonnement indigent - a poor reasoning - but it sounds somewhat pedant.

PS : did you buy a French dictionary ? A few days ago, I tried to buy a full English dictionary (Oxford or Chambers). I didn't succeed, although I went to three different "librairies" (book shops ?). Crazy - next time we go to Strasbourg, I will buy one - when I was still working, I had a big Oxford dictionary, but I gave it to my young (he is over 40 now!) friend who took over our business.

[CRL Child]

To clear up any misunderstandings, my wife and I are both retired and live permanently in France (Ajaccio - Corsica). We each have a Carte Vitale which were issued after production of letters from the UK authorities saying that the UK agreed to pay for any health treatment in France.

[azloon]

Daniel --

no, i am still shopping for a dictionary. LaRouse is a name i remember from my student days. i will start there.

of course, my reference to 'indigentes' could be indicative of a cross-gender condition which i have not yet revealed on this board. i'll say no more since i don't want to get valentin 'going." :)

so, i realized later i should have said "pour les indegent(e)s. yes?

you can buy a straight english dictionary since your english is so fluent. i have to get an french-english dictionary depuis ma francaise est si pauvre.

:)

[Daniel Strohl]

Azloon,

The dictionary's exact spelling is Larousse. Another one is Le Robert. These are the most popular, but there are other brands.

"depuis ma francaise est si pauvre" = car mon français est si pauvre (médiocre instead of pauvre would be better in this acception). But after more than 40 years, I find it quite good.

"so, i realized later i should have said "pour les indegent(e)s. yes?" Yes.(indigent(e)s)

Beware of Valentin !

PS : Thank you for your compliment regarding my fluent English. However, I would appreciate corrections from you whenever I make big mistakes. When I write outside of this blog, I use Open Office, which has a spelling checker, but no grammar corrector. Do you think that an English grammar checker would be helpful or even advisable for me ? How good are they, for instance in Word?

The French correctors are not really bad, but it is relatively easy to get them wrong purposedly when one has got a good training in French (and an AJ mind) - for instance with the sentence :
"C'est moi qui est le nouveau professeur de français qu'on vous a causé". The corrector of Word 97 didn't see anything wrong; the most recent version of Word advises the following: "C'est moi qui suis .." (this is ok) - but it sees nothing wrong in "qu'on vous a causé". This is logical - the software looks at the form, not at the meaning ...

[azloon]

daniel -- what does 'qu'on vous a cause' mean on the end of that sentence?

i have no experience with grammar checkers ('correctors' in french? an interesting word considering our analysis elsewhere of french educational emphasis).

'car' -- of course!! it's been so long. 'depuis' refers only to points in time? 'since i went to spain'... and so forth? 'ma francaise' -- now that's truly illiterate!! since i speak a bit of spanish, i end up totally hopeless in two languages besides my own. :)

ok, you asked for it: 'purposedly' should be 'purposely,' if i understand what you are trying to say. you probably just misspelled it.

c'est agreeable a savior que je suis mediocre et pas pauvre. :)

[Daniel Strohl]

Azloon,

"qu'on vous a causé" - the grammatically correct form would be "dont on vous a causé" - but this would nevertheless be totally illiterate - the intented meaning was "dont on vous a parlé". "Causer" is used in place of "parler", but is not correct in this acception.

However, if I write "le problème qu'on vous a causé ...", the grammar corrector will find this to be perfectly ok; it means "the problem that we have caused ..."

('correctors' in french? an interesting word considering our analysis elsewhere of french educational emphasis): almost a Freudian commentary ...

Thanks for "purposely" - but it was a mistake, not a lapsus.

"C'est agréable de savoir que je suis médiocre et pas pauvre" or else "C'est agréable de vous entendre dire que je suis médiocre et pas pauvre".
However, a more elegant formulation would be "Il est agréable ..."

As you may see from these examples, French grammar is not always simple ...

PS : some people use the words "vérificateur grammatical" - the word "correcteur" is somewhat presomptuous in my opinion

[azloon]

Daniel -- merci pour la lecon!

presUmptuous

[Daniel Strohl]

Azloon,

Yes, presUmptuous ! Merci pour la correction.

Next time, I will follow the advice of Frank, i.e to type my posts first with a word processor (Open Office in my case), then have them screened by its spelling checker, and after that having them saved prior to getting them over to Charles' software.

That is what I did at the beginning, with my first posts, but then I became too presUmptuous ...

[azloon]

daniel --

i wouldn't bother with all those open office preparations. i am happy to add my 'two cents worth' of correcting if you are not too embarrassed to have your 'papers' graded in public. you have so few mistakes that they are by far the exception. i, on the other hand........... my many mistakes are interspersed with suprising instances of proper usage and spelling.

:)

[Dot KING]

Daniel and Azloon, I've just spent a few excellent moments reading your exchanges - and Daniel, I can see that you like to add to your English vocabulary and usage, though they are excellent as Azloon says, so you won't have been offended by my correction of "loose" to "lose" - so nothing lost.
Please feel free to correct my French when I "slip" into it.
Funny, this is a blog about La Carte Vitale and here we are talking language and dictionairies. By the way, I'm a translator along with my teaching, and I can usually find anything I need on Amazon, either .co.uk; or .fr; and of course there's granddictionnaire.com. for in-depth word-searching.
I disactivated the corrector on my computer programmes because I don't like the red wiggly lines, which usually only highlight spelling mistakes anyway (and these are of course nothing more than fautes de frappe), and yes, isn't it reassuring to know that our minds can still sometimes beat the computer.
I'd be more than happy to let you have my private co-ordonnées if you'd like my help with your written English. Don't hesitate.

[Clair]

A lobbying website has been created by concerned British residents in France to highlight the potential difficulties the changes to health cover will cause: http://www.frenchhealthissues.eu/

Unfortunately, tBritish citizens legally residing in France for over 5 or 10 years have already been advised they will cease to have medical cover after 31st March 2008.

Furthermore, those who have pre-existing medical conditions are unlikely to obtain a comprehensive medical cover for these conditions and their potential consequences. These people will effectively become stateless in terms of medical cover, as they are unable to obtain NHS treatment after residing abroad for more than 3 months.
Most British residents have complied with French residency law as it was when they settled in France. They have contributed the required 8% of their taxable income to the French health system. In applying the EU ruling, the French government has now changed the residency rules to include all those who were already residing legally in France and will effectively make them illegal immigrants.

All those concerned should at the very least look at the website and draw their own conclusions.
Now is the time to lobby your MP and MEP: http://www.frenchhealthissues.eu/