Is the Public-Private Mix in French Health System Sustainable?

France is known for having one of the best health care systems in the world. Indeed, its responsiveness is rated high; patients have a large choice of public and private providers without chronic waiting time problems observed in some OECD countries. Out-of-pocket payments are among the lowest in OECD area and the health status of the population ranks amongst the best in the world. However, promoting a universal health system built on a mix of public and private funding and provision raises numerous challenges to ensure equity and efficiency in the system. In this Working Paper, we present the unique public/private mix of healthcare funding and delivery in France and discuss to what extent this mix contributes to achieving overall health system goals of better health outcomes, equity and efficiency. We first explain the role of public and private insurances in healthcare funding and discuss the increasing regulation of private health insurers to align them with public objectives as an attempt to overcome the limits of current public insurance model. We then describe the place of private providers in care delivery and the implications of this plurality on care quality, efficiency, and access to care. By discussing the most recent measures tackling the issues in public-private mix in French health system, we suggest some avenues for improvement.