New French Premier Outlines Health Policy

France's new premier, Alain Juppe, has given a few outlines of future health policy in his address to Parliament. A new council will be set up alongside the Ministry of Health to supervise the reform of hospital spending, and a major program of research will be launched in the area of human genetics.

Meantime, the idea that the provision of health care generates ever-increasing consumption has received a knock from a study by the major French health fund CNAM. This appears to show that there is no direct, mechanical relationship between the rise in medical density (number of doctors per 100,000 of population) and a rise in spending on out-patient care. The study, carried out in the metropolitan departments where medical density rose 10% in 1994, showed an average rise in reimbursement of 6.7%. CNAM suggests, however, that medical density remains the main factor explaining health spending.

Factors influencing consumption were variously weighted. In an average-size department, medical density accounted for 47% of consumption, while patients over 70 accounted for 24% and the local mortality quota for 21%. Variations between areas were significant; the extent of health care provision was under 36% of consumption in Creuse, Indre and Lozere, but over 66% in the Rhone and 71% in haute-Savoie. The patient-age factor was weak in some departments but exceeded 30% in other, mainly rural, areas.