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World Health Systems Facts

France: Health System Overview


Life expectancy at birth (years), 2021: 81.9 years
Maternal mortality ratio (per 100,000 live births), 2023: 7
Under-five mortality rate (per 1000 live births), 2023: 4.3
Neonatal mortality rate (per 1000 live births), 2023: 2.7
New HIV infections (per 1000 uninfected population), 2023: <0.1
Tuberculosis incidence (per 100,000 population), 2023: 8.3
Probability of dying from any of cardiovascular disease, cancer, diabetes, chronic respiratory disease between age 30 and exact age 70 (%), 2021: 10.2%
Suicide mortality rate (per 100,000 population), 2021: 16.6
Adolescent birth rate (per 1000 women aged 15-19 years), 2015-2024: 3.5
Universal Health Coverage: Service coverage index, 2021: >80
Diphtheria-tetanus-pertussis (DTP3) immunization coverage among 1-year-olds (%), 2023: 96%
Measles-containing-vaccine second-dose (MCV2) immunization coverage by the locally recommended age (%), 2023: 93%
Pneumococcal conjugate 3rd dose (PCV3) immunization coverage among 1-year olds (%), 2023: 96%
Human papillomavirus (HPV) immunization coverage estimates among 15 year-old girls (%), 2023: 45%
Density of medical doctors (per 10,000 population), 2015-2023: 32.81
Density of nursing and midwifery personnel (per 10,000 population), 2016-2023: 94.22
Density of dentists (per 10,000 population), 2016-2023: 6.94
Density of pharmacists (per 10,000 population), 2015-2023: 9.34
Domestic general government health expenditure (GGHE-D) as percentage of general government expenditure (GGE) (%), 2022: 15.25%
Prevalence of anaemia in women aged 15-49 years (%), 2023: 13.1%

Source: World health statistics 2025: monitoring health for the SDGs, Sustainable Development Goals. Tables of health statistics by country and area, WHO region and globally. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.


Health expenditure per capita, USD PPP, 2022
– Government/compulsory: $5,622
– Voluntary/Out-of-pocket: $1,007
– Total: $6,630
Health expenditure as a share of GDP, 2022
– Government/compulsory: 10.3%
– Voluntary/out-of-pocket: 1.8%
Health expenditure by type of financing, 2021
– Government schemes: 4%
– Compulsory health insurance: 81%
– Voluntary health insurance: 6%
– Out-of-pocket: 9%
– Other: 1%
Out-of-pocket spending on health as share of final household consumption, 2021: 2.2%
Price levels in the healthcare sector, 2021 (OECD average = 100): 70
Population reporting unmet needs for medical care, by income level, 2021
– Lowest quintile: 4.5%
– Highest quintile: 1.5%
– Total: 2.8%
Main reason for reporting unmet needs for medical care, 2021
– Waiting list: 1.0%
– Too expensive: 1.6%
– Too far to travel: 0.2%
Population reporting unmet needs for dental care, by income level, 2021
– Lowest quintile: 9.4%
– Highest quintile: 2.2%
– Total: 5.4%
Population coverage for a core set of services, 2021
– Total public coverage: 100%
Population aged 15 years and over rating their own health as bad or very bad, 2021: 8.9%
Population aged 15 years and over rating their own health as good or very good, by income quintile, 2021
– Highest quintile: 80.1%
– Lowest quintile: 58.3%
– Total: 67.8%
Life expectancy at birth, 2021: 82.4 years
Infant mortality, deaths per 1,000 live births, 2021: 3.6
Maternal mortality rate, deaths per 100,000 live births, 2020: 7.9
Congestive heart failure hospital admission in adults, age-sex standardized rate per 100,000 population, 2019: 287
Asthma and chronic obstructive pulmonary disease hospital admissions in adults, age-sex standardized rate per 100,000 population, 2019: 159
Hospital workforce per 1,000 population, 2021
– Physicians: 2.69
– Nurses and midwives: 5.7
– Healthcare assistants: 3.71
– Other health service providers: 1.07
– Other staff: 6.84
Practicing doctors per 1,000 population, 2021: 3.2
Share of different categories of doctors, 2021
– General practitioners: 30.4%
– Specialists: 56.6%
– Other doctors: 13.1%
Share of foreign-trained doctors, 2021: 12.3%
Medical graduates per 100,000 population, 2021: 11.9
Practicing nurses per 1,000 population, 2021: 9.7
Share of foreign-trained nurses, 2021: 3.1%
Nursing graduates per 100,000 population, 2021: 36.2
Ratio of nurses to doctors, 2021: 2.7
Practicing pharmacists per 100,000 population, 2021: 92
Community pharmacies per 100,000 population, 2021: 31
Remuneration of doctors, ratio to average wage, 2017
– General Practitioners
– Self-employed: 3.0
– Specialists
– Salaried: 2.2
– Self-employed: 5.1
Remuneration of hospital nurses, ratio to average wage, 2021: 1.0
Remuneration of hospital nurses, USD PPP, 2021: $46,000
Hospital beds per 1,000 population, 2021: 5.7
Average length of stay in hospital, 2021: 9.1 days
Average number of in-person doctor consultations per person, 2021: 5.5
CT scanners per million population, 2021: 20
CT exams per 1,000 population, 2021: 218
MRI units per million population, 2021: 17
MRI exams per 1,000 population, 2021: 136
PET scanners per million population, 2021: 3
PET exams per 1,000 population, 2021: 12
Proportion of primary care practices using electronic medical records, 2021: 80%
Expenditure on retail pharmaceuticals per capita, USD PPP, 2021
– Prescription medicines: $646
– Over-the-counter medicines: $55
– Total: $701
Expenditure on retail pharmaceuticals by type of financing, 2021:
– Government/compulsory schemes: 83%
– Voluntary health insurance schemes: 5%
– Out-of-pocket spending: 12%
– Other: 0%
Share of the population aged 65 and over, 2021: 21.4%
Share of the population aged 65 and over, 2050: 27.4%
Share of the population aged 80 and over, 2021: 6.3%
Share of the population aged 80 and over, 2050: 11.1%
Adults aged 65 and over rating their own health as good or very good, 2021: 45%
Adults aged 65 and over rating their own health as poor or very poor, by income, 2021
– Lowest quintile: 25%
– Highest quintile: 10%
– Total: 17%
Limitations in daily activities in adults aged 65 and over, 2021
– Some Limitations: 25%
– Severe Limitations: 16%
Share of adults aged 65 and over receiving long-term care, 2021: 9.4%
Estimated prevalence of dementia per 1,000 population, 2021: 17.3
Estimated prevalence of dementia per 1,000 population, 2040: 24.0
Total long-term care spending as a share of GDP, 2021: 2.6%
Share of informal carers among the population aged 50 and over, 2019
– Daily carers: 8%
– Weekly carers: 7%
Share of long-term care workers who work part time or on fixed contracts, 2021
– Part-time: 39%
– Fixed-term contract: 15.2%
Average hourly wages of personal care workers, as a share of economy-wide average wage, 2018
– Residential (facility-based) care: 71%
– Home-based care: 69%
Long-term care beds in institutions and hospitals per 1,000 population aged 65 years and over, 2021
– Institutions: 47.4
– Hospitals: 2.2
Long-term care recipients aged 65 and over receiving care at home, 2021: 60%
Total long-term care spending by provider, 2021
– Nursing home: 61%
– Hospital: 7%
– Home care: 24%
– Households: 0%
– Social providers: 0%
– Other: 7%

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.


Population, 2021: 64,531,000
Annual Population Growth Rate, 2020-2030 (%): 0.1%
Life Expectancy at Birth, 2021: 82
Share of Urban Population, 2021: 81%
Annual Growth Rate of Urban Population, 2020-2030 (%): 0.4%
Neonatal Mortality Rate, 2021: 3
Infant Mortality Rate, 2021: 3
Under-5 Mortality Rate, 2021: 4
Maternal Mortality Ratio, 2020: 8
Gross Domestic Product Per Capita (Current USD), 2010-2019: $40,496
Share of Household Income, 2010-2019
– Bottom 40%: 23%
– Top 20%: 37%
– Bottom 20%: 9%
Gini Coefficient, 2010-2019: 29
Palma Index of Income Inequality, 2010-2019: 1.1

Note: “Under-5 mortality rate – Probability of dying between birth and exactly 5 years of age, expressed per 1,000 live births.
“Infant mortality rate – Probability of dying between birth and exactly 1 year of age, expressed per 1,000 live births.
“Neonatal mortality rate – Probability of dying during the first 28 days of life, expressed per 1,000 live births.”
“Maternal mortality ratio – Number of deaths of women from pregnancy-related causes per 100,000 live births during the same time period (modelled estimates).”
Gini coefficient – Gini index measures the extent to which the distribution of income (or, in some cases, consumption expenditure) among individuals or households within an economy deviates from a perfectly equal distribution. A Gini index of 0 represents perfect equality, while an index of 100 implies perfect inequality.
Palma index of income inequality – Palma index is defined as the ratio of the richest 10% of the population’s share of gross national income divided by the poorest 40%’s share.

Source: United Nations Children’s Fund, The State of the World’s Children 2023: For every child, vaccination, UNICEF Innocenti – Global Office of Research and Foresight, Florence, April 2023.


Population, Midyear 2022: 64,626,628
Population Density (Number of Persons per Square Kilometer): 117.21
Life Expectancy at Birth, 2022: 83.23
Infant Mortality Rate, 2022 (per 1,000 live births): 3.30
Under-Five Mortality Rate, 2022 (per 1,000 live births): 3.91
Projected Population, Midyear 2030: 65,543,453
Percentage of Total Population Aged 65 and Older, Midyear 2022: 21.66%
Projected Percentage of Total Population Aged 65 and Older, Midyear 2030: 24.42%
Projected Percentage of Total Population Aged 65 and Older, Midyear 2050: 28.55%

Source: United Nations, Department of Economic and Social Affairs, Population Division (2023). Data Portal, custom data acquired via website. United Nations: New York. Accessed 12 May 2023.


Current health expenditure (CHE) per capita in US$, 2022: $4,865.18

Source: Global Health Observatory. Current health expenditure (CHE) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Out-of-pocket expenditure (OOP) per capita in US$, 2022: $434.13

Source: Global Health Observatory. Out-of-pocket expenditure (OOP) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%), 2022: 8.92%

Source: Global Health Observatory. Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Domestic private health expenditure (PVT-D) as percentage of current health expenditure (CHE) (%), 2022: 24.57%

Source: Global Health Observatory. Domestic private health expenditure (PVT-D) as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Domestic private health expenditure (PVT-D) per capita in US$, 2022: $1195.50

Source: Global Health Observatory. Domestic private health expenditure (PVT-D) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Domestic general government health expenditure (GGHE-D) as percentage of current health expenditure (CHE) (%), 2022: 75.43%

Source: Global Health Observatory. Domestic general government health expenditure (GGHE-D) as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Domestic general government health expenditure (GGHE-D) as percentage of gross domestic product (GDP) (%), 2022: 8.96%

Source: Global Health Observatory. Domestic general government health expenditure (GGHE-D) as percentage of gross domestic product (GDP) (%). Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Domestic general government health expenditure (GGHE-D) per capita in US$, 2022: $3,669.68

Source: Global Health Observatory. Domestic general government health expenditure (GGHE-D) per capita in US$. Geneva: World Health Organization. Last accessed Jan. 23, 2025.


Annual household out-of-pocket payment in current USD per capita, 2020: $426

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed May 13, 2023.


Total Health Spending, USD PPP Per Capita (2021): $6,106

(Note: “Health spending measures the final consumption of health care goods and services (i.e. current health expenditure) including personal health care (curative care, rehabilitative care, long-term care, ancillary services and medical goods) and collective services (prevention and public health services as well as health administration), but excluding spending on investments. Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”) as well as voluntary health insurance and private funds such as households’ out-of-pocket payments, NGOs and private corporations (“Voluntary”). This indicator is presented as a total and by type of financing (“Government/compulsory”, “Voluntary”, “Out-of-pocket”) and is measured as a share of GDP, as a share of total health spending and in USD per capita (using economy-wide PPPs).”

Source: OECD (2023), Health spending (indicator). doi: 10.1787/8643de7e-en (Accessed on 21 November 2023).


Population Insurance Coverage For A Core Set Of Healthcare Services (%) (2019):
Public Coverage: 100%; Primary Private Health Coverage: %; Total: 100%

Note: “Population coverage for health care is defined here as the share of the population eligible for a core set of health care services – whether through public programmes or primary private health insurance. The set of services is country-specific but usually includes consultations with doctors, tests and examinations, and hospital care. Public coverage includes both national health systems and social health insurance. On national health systems, most of the financing comes from general taxation, whereas in social health insurance systems, financing typically comes from a combination of payroll contributions and taxation. Financing is linked to ability-to-pay. Primary private health insurance refers to insurance coverage for a core set of services, and can be voluntary or mandatory by law (for some or all of the population.”)”

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.


“The health system provides near universal coverage through a publicly financed statutory health insurance scheme. The publicly financed benefits package is considered generous in terms of the scope of its coverage, but user charges are applied to most services, mainly in the form of coinsurance (except for treatment for chronic conditions covered by the affections de longue durée (ALD) scheme).

“Patients have access to public and private hospitals. Hospital treatment requires 20% coinsurance from patients. Coinsurance is not needed for costly surgeries. Patients also pay a lump sum per day in hospital for food. Outpatient care involves three types of user charges: coinsurance, extra-billing and deductibles. Coinsurance rates are 30% for physician and dentist care and 40% for ancillary services and laboratory tests. For most medicines, coinsurance amounts to either 70 or 35%, but ranges from 0% for non-substitutable or expensive medicines, to 85% for so-called convenience medicines. Some outpatient specialists use extra-billing.”

Source: Karine Chevreul, Karen Berg Brigham and Marc Perronnin. “France.” Voluntary health insurance in Europe: Country experience [Internet]. Sagan A, Thomson S, editors. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2016. Observatory Studies Series, No. 42.


“France’s health system is based mainly on a social health insurance (SHI) system, with a traditionally strong role for the state. While regional health agencies have played a greater role in managing provision of healthcare – and especially hospital care – at the local level since 2009, SHI and central government play a strong role in organising the health system and determining its operating conditions. Over the past two decades, the state has also become more involved in controlling health expenditure funded by the SHI system by setting a national health spending target.”

Source: OECD/European Observatory on Health Systems and Policies (2023), France: Country Health Profile 2023, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“The SHI [Social Health Insurance] system offers coverage to the whole population based on residence through various compulsory schemes. Revenue for healthcare comes from social security contributions, earmarked income taxes, value-added taxes and other sources such as tobacco and alcohol taxes.

“Nearly everyone (95 %) has complementary health insurance, mainly to cover copayments and to attain better coverage for medical goods and services that are poorly covered by the SHI system, such as dental and optical care (although since 2021 public coverage for dental and optical care has improved substantially (see Section 5.2)). In 2021, public and private compulsory complementary health insurance schemes funded 85 % of all health
spending in France – higher than the EU average of 81 %.5“

Source: OECD/European Observatory on Health Systems and Policies (2023), France: Country Health Profile 2023, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“The French healthcare system is structurally based on a Bismarckian (SHI) [Statutory Health Insurance] approach, with goals of universality and solidarity that have led to an increasingly Beveridgian-type (NHS) [National Health Insurance] system. The SHI currently covers 100% of the resident population (including undocumented migrants under certain conditions). Jurisdiction over health policy and regulation of the healthcare system (Fig. 2.1) is divided among:

“ƒ the State: parliament and the government, specifically the Ministry of Health3
“ƒ the SHI; and
“ƒ to a lesser extent, local authorities (départements).

“Delivery of care is shared among private, fee-for-service (FFS) physicians and other health professionals, private for-profit hospitals, private non-profit hospitals and public hospitals. The current institutional organization of the health system is the result of the will of the founders of the social security system to create a single block system, guaranteeing uniform rights for all. Health insurance in France has, therefore, always been more concentrated and uniform than in other Bismarckian systems.”

Source: Or Z, Gandré C, Seppänen AV, Hernández-Quevedo C, Webb E, Michel M, Chevreul K. France: Health system review. Health Systems in Transition, 2023; 25(3): i–241.


“The SHI [Statutory Health Insurance] is composed of three categories of schemes, which cover the entire population. Individuals and their families are affiliated with a scheme based on employment status. Working people have no choice regarding the scheme in which they are enrolled and may not opt out of coverage except in certain cases (for example, expatriates and employees of international corporations or institutions). Thus, there is no competition among the schemes. Persons who are not working are automatically enrolled in the general scheme, which is the major scheme.

“The three categories of schemes and their beneficiaries in 2020 are approximately as follows:

“1. the general scheme (Caisse nationale d’assurance maladie, CNAM)covers everybody (around 88% of the population) except thoseeligible for other schemes (CNAM, 2021k);
“2. the agricultural scheme (Mutualité sociale agricole, MSA) coversfarmers and agricultural employees and their families (around 5% of the population); and
“3. the numerous “special schemes”, over 20 in number, built upon preSHI prepayment systems for defined categories of workers: localand national civil servants, miners, military personnel, employees of the national railway company, the clergy, sailors, the national bank, the gas and electricity company (they cover 7% of the population but technically manage claims and benefits for hardly 3%) (UNRS,2022) (see Section 3.3.1).

“These schemes are federated into a National Union of Health Insurance Funds (Union nationale des caisses d’assurance maladie, UNCAM) for the purpose of representing the funds in negotiations with healthcare providers.

“Each of the two major health insurance schemes is made up of a national health insurance fund and local structures corresponding to the degree of geographical distribution involved.”

Source: Or Z, Gandré C, Seppänen AV, Hernández-Quevedo C, Webb E, Michel M, Chevreul K. France: Health system review. Health Systems in Transition, 2023; 25(3): i–241.


“France has more than 600 mostly private nonprofit and for-profit complementary insurers (similar to Medigap coverage in the US) that provide partial reimbursement for out-of-pocket expenses for the same benefit package covered under universal health insurance and for supplementary benefits, mostly dental and optician services. Employers are required to offer and finance half of the premium costs to provide a minimal level of complementary health insurance for their salaried employees. For those below a poverty income ceiling, a minimum package of complementary insurance benefits is available without premium charges; this covers all coinsurance payments for physicians who accept universal health insurance tariffs as payment in full. Unemployed people maintain their usual coverage, as there is no “job lock,” and their complementary insurance is ensured for up to one year of unemployment.”

Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.


“The general philosophy underlying decentralization in France reflects a marked reluctance to reduce central control over policy and finance, and as a result it has mainly come in the form of deconcentration. The creation of the ARS [Regional health agency, Agence régionale de santé] in 2010 changed the regional landscape by merging seven regional institutions into a single regional entity traversing the traditional boundaries of healthcare, public health, and health and social care for elderly and disabled people.

“The 18 ARS (13 for mainland France and 5 for overseas departments) are responsible for ensuring that the provision of healthcare services meets the needs of the population by improving the coordination between the ambulatory and hospital sectors and health and social care sector services, while respecting national objectives for SHI spending (ONDAM). It is also responsible for implementing regional health policy in relation to occupational health services, maternal and child protection services (Protection maternelle et infantile, PMI), and university and school health services.

“The ARS monitor the regional health status of the population, ensure that hygiene rules are respected, participate in prevention and patient health education, and assess health professionals’ education. They authorize the creation of new health services and social care services for the elderly and disabled. In the environmental health sector they oversee water and air quality.”

Source: Or Z, Gandré C, Seppänen AV, Hernández-Quevedo C, Webb E, Michel M, Chevreul K. France: Health system review. Health Systems in Transition, 2023; 25(3): i–241.


France: Health System Overview - National Policies - outcomes, expenditures, equity, coverage, access, mortality, life expectancy - World Health Systems Facts

French Health System Overview
Health System Rankings
Health System Outcomes
Coverage and Access
Costs for Consumers
Health System Expenditures
Health System Financing
Preventive Healthcare

Healthcare Workers
Health System Physical Resources and Utilization
Long-Term Services and Supports
Health Information and Communications Technologies
Healthcare Workforce Education and Training
Pharmaceuticals

Political System
Economic System
Population Demographics
People with Disabilities
Aging
Social Determinants and Health Equity
Health System History
Reforms and Challenges
Wasteful Spending


World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated July 21, 2025 by Doug McVay, Editor.

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