This document provides an overview of the social protection system in France. It discusses the origins of the modern social security system in France dating back to the late 19th century. It describes how the current system was established after World War II, combining elements of the Bismarck and Beveridge models. The social protection system in France is comprised of four main branches - illness, old age/retirement, family, and work accident/occupational disease. It is financed through social contributions and assigned taxes, and provides allowances and benefits to citizens to protect them against various social risks.
2. INTRODUCTION
Welfare in France includes all systems whose purpose is to protect people against the financial
consequences of social risks (illness, maternity, old age, unemployment). Social welfare refers to all
the mechanisms of collective anticipation, enabling individuals to cope with the financial
consequences of all the social risks. These are situations that could endanger the economic security
of the individual or his family causing a decline in its resources or increase its expenditures (old age,
sickness, disability, unemployment, maternity, family responsibilities, etc.). In France, the welfare
system make up for about 500 billion euros annually, or more than 30% of GDP (Gross Domestic
Product).
The French welfare state is a mixed system combining elements of various organizational
models: it lies between the Beveridge and Bismarck models, with insurance funds and strong state
intervention, and relies both on wage related contributions and general taxation. In the health sector
for instance, it combines public and complementary voluntary health insurance, which finance the
same services by the same providers for the same populations. It is a publicly funded system
characterized by freedom of choice and unrestricted access for patients along with freedom of
practice for professionals. These factors combine to make it difficult for the state to control
expenditure, taking into account that health insurance funds have no real financial responsibility.
When creating Social Security, France imitated more the Bismarckian system (insurance for
workers) than the Beveridge one (widespread solidarity). Over the years, the solidarity (as opposed
to a system of contributions) has gradually developed in the French system, which the foundation
remains the concept of insurance. However, the desire to establish a universal system has faced
opposition. This explains why the French welfare system is plural, with a wide variety of actors. The
most important is the general scheme for employees of industry, commerce and services.
3. SOCIAL PROTECTION IN FRANCE
The origin of social protection in France dates back to medieval times. In the second half of the
nineteenth century, systems of social assistance developed gradually, often launched by employers
marked by social Catholicism, then relayed by the first laws. In 1930, modern social insurance was
created, offering employees protection against certain risks: accidents, sickness, disability,
maternity, old age, death ... During the Second World War, the National Council of Resistance
designed the system of social security, now at the heart of social protection. It was created just after
the Liberation, by an order of 4 October 1945, which aimed to cover all the so-called ‘social risks’.
A reform of the organization of social security took place in 1967. It was separated into four
branches: health insurance (which represents the largest share of expenditures devoted to social
protection), pensions, family allowances, and insurance for work-related accidents and occupational
illnesses. The provision of social security was aimed primarily at workers and their families. The
principle of expanding coverage to the whole population was put into practice only in stages.
Management of the boards of health insurance funds has traditionally been shared between the
state and the “social partners” (representatives of employees and employers appointed by trade
unions).
Against a background of slow economic growth and spreading unemployment, the health system
has undergone significant changes: one of the most important took place in 2000 in the form of the
Universal Health Coverage Act which establishes universal health coverage on the basis of
residence in France. The Universal Health Coverage Act aims to increase access for people on low
incomes who are exempt from paying contributions. This evolution introduced two important
changes: the creation of a tax on income in the funding of the social security system and a more
active role for parliament in determining policy directions and expenditure targets in each branch of
the system.
The pension branch also underwent significant changes: in 1993, the Government decided on a
reduction of benefits in the scheme covering private sector employees. Two years later, an attempt at
cutting pensions for public sector employees resulted in a massive protest movement that forced the
right-wing Government to withdraw their plans.
Contrary to the pension system, the family policy branch has been immune to cutbacks in
4. provision and no retrenchment measures have been implemented. This reflects the fact that the
family branch and its large network of Local Allowance Funds are responsible for the management
of welfare state provisions.
The family branch is a transfer-heavy system which aims at reducing social inequalities and
fighting against poverty: for instance they provide more than one million households with the
*Minimum Income Benefit (RMI) introduced in 1988. It also provides families with a rich array of
universal cash benefits that aim to lighten the financial burden for families irrespective of their
income. These measures are successful in reducing the poverty rate among families, in particular
lone parent families. Despite the dramatic increase since the nineties in the number of welfare
recipients, no real welfare-to-work programmes have been adopted.
Social Contributions
In recent years, the share of resources financing social protection has been changing.
Traditionally, French social protection was financed by contributions rather than by taxes. Over the
last three decades, there has been a reduction in the proportion of contributions and an increase in
funding from broader fiscal measures. In particular, revenue from the General Social Contribution,
created in 1991, has increased considerably to become the second most important fiscal stream in
France. This development has arisen from the need to finance social protection not only with
deductions from earnings, but also from a broader base. It also helps distinguish the financing of
benefits corresponding to national solidarity from those covered by insurance. France has thus come
closer to the average European Union member's social protection financing structure, although it
remains among the countries having the highest percentage of direct contributions relative to
earnings.
Social security contributions are mandatory payments made by the self-employed and employees
(and their employers) to acquire rights to social benefits. They are not considered taxes in France,
while in many Anglo-Saxon countries these contributions correspond to the payroll tax (or to a
"pseudo-tax" by simply being added to total government revenue). The distinction between taxes
and contributions is justified by the fact that contributions provide for direct benefits, while taxes are
part of a solidarity system. In 2004, the new solidarity contribution for autonomy has been
implemented. Private and public employers for pay for health insurance.
5. Social contributions represent a major part of social welfare (66% in 2007). Indeed, social
protection was built in France on the logic of social insurance system inspired and implemented by
Bismarck in Germany in the late nineteenth century. Their proportion has tended to decrease since
the 1990s, because they are being replaced by fiscal resources, but also because of various
contribution exemptions.
Assigned Taxes
The funding by the tax "assigned taxes" constitutes a growing share of Social Welfare (nearly
21% in 2007, excluding transfers). This increase responds to the need not to weigh the financing of
social benefits solely on labor income, and distinguish the financing of benefits under the National
Solidarity and those of insurance. The "assigned taxes" are fiscal resources allocated to the financing
of social benefits. They include:
− Transfers of tax revenue permanently paid to the scheme of farmers;
− Some taxes on products (excise duties on alcohol and tobacco, taxes on car insurance, taxes on
polluting activities);
− Taxes on wages and labor;
− Taxes on income and wealth. They constitute the largest share of "assigned taxes". Among
them is the general social contribution (CSG), founded in 1991. The CSG is the main fiscal
resource for the social protection (66% of assigned taxes in 2007).
Allowances
Social benefits amount to 30% of gross domestic product and around 45% of household income.
Three quarters of these benefits are paid by social security. The Social Welfare Report, published
annually distinguishes five categories of benefits for as many risks:
− The pension and survival risk. The most important, it represents 44% of benefits, due to the
weight of pensions.
− The health risk. It includes illness, disability, occupational accidents and diseases. In 2006, it
accounted for 35% of benefits.
− The maternity and family risk. It includes daily allowances, the allowance for young children,
family allowances, aid for child care and the bulk of housing assistance. It represents 9% of
6. benefits
− The employment risk. It consists of unemployment benefits, aid to reinsertion and professional
rehabilitation, and early retirement, accounting for 7% of benefits
− The risk of poverty and exclusion. It is taken in charge by 80% by the minimum income
(RMI), and accounts for 2% of benefits.
Organisation
The social protection is largely dependent on the state. The state is a key player in the field of
social protection. It produces legal texts, oversees the various agencies (including the Social
Security administrations) and partly finances social protection through taxes or subsidies. However,
it plays a role more or less important in the various forms of social protection. Social protection is
organized into four levels.
The Social Security administrations provide basic coverage of four kinds of risks: "illness,
maternity, disability, death", "accidents, illnesses", "old age" and "family". Each of these four risks
corresponds to a branch. The system is divided in different schemes classifying people according to
their professional activity. These four schemes are:
− General scheme: it includes most employees, students, recipients of certain benefits and
ordinary residents;
− Special schemes (including the special retirement plans): they cover employees who are not
in the private sector (civil servants);
− Agricultural scheme: it assures the welfare of farmers and agricultural workers;
− Autonomous scheme: they cover separate artisans, merchants, industrials and liberal
professions for old age only (the risk of "disease" is treated in the common system).
Social Security administrations, established by the State in 1945, are managed by the social partners
(employers' representatives and trade unions). The resources of Social Security (payroll taxes, i.e.
social contributions) and expenses (benefits and allowances) have been determined since 1996 by
the laws of social security funding, voted annually by the Parliament. The funds are collected by the
URSSAF (network).
SOCIAL SECURITY IN FRANCE
7. Social security in France is divided into four branches: illness; old age/retirement; family; work
accident and occupational disease. From an institutional point of view, French social security is
made up of diverse organismes. The system is divided into three main Regimes: the General
Regime, the Farm Regime and the Self-employed Regime. In addition there are numerous special
regimes dating from prior to the creation of the state system.
History of Social Protection
From the Middle Ages, certain professional organizations provided limited assistance to their
members. However, the abolition of corporations by the Allarde decree, in 1791, put an end to this
early system of private professional collective security. It was nevertheless replaced by the sociétés
de secours mutuels, or societies for mutual support, recognized and strictly regulated by the 1835
Humann law. These sociétés would thereafter be free from administrative control, and were
encouraged by the law of 1 April 1898, referred to as the Charter of mutuality. The 1898 law
establishes the principles of mutualisme, as they are found today in French law; mutuelles—
organizations for collective social insurance—were permitted to offer loans to any French person,
even if at the beginning, interest rates were too high for the average person.
Alongside the movement for mutual, private social insurance, legislators pushed state-sponsored
social aid, which tended to nurture the principle of national solidarity. The law of 15 July 1893,
instituted free medical assistance; the law of 9 April 1898, considerably facilitated the worker
compensation claims; the law of 27 June 1904, created the service départemental d'aide sociale à
l'enfance, a childbirth assistance program; and on 14 July 1905, an elderly and disabled persons
assistance program was initiated. France also had, by the 1900s, the most extensive network of child
welfare clinics and free or subsidized milk supplies in the world.
The development of insurance companies, at the beginning of the 20th century, was also
encouraged by legislation. On 9 April 1898, legislators required that employers purchase insurance
for indemnity payments to injured employees. Then, on 5 April 1928, insurance was extended to
cover illness, maternity, and death. On 30 April 1930, the law was again extended to apply to jobs in
the agricultural sector.
The bill was supported by Pierre Laval, who went on to serve as the French Prime Minister from
1942 to 1944, in the Vichy government. As a result, historian Fred Kupferman has called Laval "the
8. father of social security" in France.
During the Second World War, the National Council of the French Resistance adopted plans to
create a universal social security program to cover all citizens, regardless of class, in the event that
sickness or injury made them unable to work. In the U.K., the first report of British economist
William Beveridge outlined the general principles that would govern the integration and evolution
of social security in post-war France. Indeed, the ordonnances of 4 and 19 April 1945, created a
generalized, national social security system similar to that described in Beveridge's plan.
Today’s History
The Social Security is financed by payments from both employers and their employees; it is
administered and managed by all social partners, typically employee unions and/or companies.
The Constitution of the IVth Republic, adopted by referendum in 1946, a constitutional state
obligation to provide financial assistance to those deemed most socially vulnerable, most notably
women, children, and retired workers.
Nonetheless, social security was not entirely universal. The CNR program—the national
resistance council—had envisioned universal social security, but the régime général, or unified
social security program, actually created excluded miners, sailors, farmers, and government
employees, all of whom were covered by régimes particuliers, or special administrative bodies.
Finally, the law of 22 May 1946, limited coverage under the unified s.s. program to employees of
the industrial and commercial sectors.
In the following decades, the unified s.s. program would gradually be extended by various laws:
− 9 April 1947: extended social security to government workers;
− 17 January 1948: established three retiree insurance programs for non-salaried, non-farm
employees (artisans, industrial and commercial workers, and among the liberal professions);
− 10 July 1952: established mandatory retiree insurance program for farmers, managed by the
mutualité sociale agricole (MSA);
− 25 January 1961: established mandatory health insurance for farmers, allowing them choice
among providers;
− 22 December 1966: established mandatory insurance programs for farm-related accidents,
non-work related accidents, and work-related sicknesses with free-choice of provider;
9. − 25 October 1972: protection enforcement of salaried farm-workers against work-related
accidents, written into law;
− 4 July 1975: universalized retiree insurance mandatory for working population;
− 22 January 1978: establishment of unique program for ministers, religious congregation
members, and personal insurance other non-covered persons;
− 28 July 1999: the complete institutialization of universal health care.
Allowances by Branch
Diseases
The sickness insurance covers the cost of general medicine and special care and dentures,
Pharmaceutical expenses and equipment, analysis and laboratory tests; hospitalization and treatment
heavy care facilities, rehabilitation, prenuptial examination vaccinations, tests done in public health
programs; accommodation and treatment of children or adolescents with disabilities. In case of
sickness, health insurance provides daily allowances to the insured who is in physical disability and
unable to continue or resume work. The daily allowance depends on the daily earning and on the
number of dependent children. Health insurance also manages maternity (expenses for examinations
and daily allowance during maternity leave) disability: (pension granted when the person is unable
to work) and deaths.
In order to be taken in charge by health insurance, care and products must meet two conditions:
being provided by a public or private practitioner duly authorized to exercise, and being included on
the list of reimbursable drugs and products. Health insurance operates on the basis of tariffs set by
convention or authority. Health insurance does not support all the expenses within the rates used to
calculate benefits. In principle, the insured is required to advance the expenses, social security then
reimbursing the insured. However, there are some conventions of "third-party payer" providing
direct payment for the body to the service.
Health insurance depends on his professional past or present of a person. However, for those not
fulfilling the conditions of membership on a professional basis but residing in France for at least
three months in a regular situation, there is universal coverage.
The insured entitlement to benefits in kind of health insurance and maternity his spouse or partner
when it does not have a system of social protection, dependent children and any person taken in
10. charge by the insured and who does not benefit from a system of social protection.
Universal Health Coverage
From 2000 a universal health coverage has been in place, providing two fundamental rights for
access to care: a right to health insurance for anyone in stable and regular residence in the territory
and a right for the most disadvantaged, submitted to resources, to a free coverage, with exemption
from fee.
The first component, for basic coverage, improves access to care for people suffering from
extreme exclusion, but also many people temporarily or permanently deprived of the right to health
insurance. It also introduced the principle of continuity of rights: a caisse can stop paying benefits
only if another caisse takes over or if the insured person leaves the country.
The second component, the creation of an additional free coverage, on behalf of national
solidarity, is included in the management of care by health insurance. This reform affects 10% of the
most disadvantaged people meeting the criteria of resources and residence.
Accidents at work
The accident insurance and occupational diseases is a branch of social security often managed by
the same agencies that the health branch. It is the oldest social security body. The legislation go back
to 1898 and were included in the 31 December 1946 law creating the Social Security.
There are three social accidents for which the risk is better covered than by the accident
assurance health insurance. The accident at work is the accident, whatever the cause, occurring
because of or in connection with a job, to any person employed by one or more employers or
entrepreneurs. Travel accident is an accident occurring on a route between work and home or during
a mission on behalf of the employer. A professional disease is a disease of occupational origin and
included in a list indicating any occupational diseases, their causes and the duration of incubation.
In these three cases, industrial accident, travel from home, and occupational disease, medical care
and vocational rehabilitation are totally taken in charge by the Social Security.
In case of permanent reduction of working capacity, the victim is entitled a capital (if the rate of
permanent disability is less than 10%), and an annuity (if the rate is more than 10%). In case of the
death of the insured, the beneficiaries (spouse, children and descendants dependents) receive a
11. pension.
Family
Family benefits consist of:
− The family allowances granted from the 2nd dependent child, a fixed amount per child from
the 3rd;
− The Family Complement assigned to the household or the person whose resources do not
exceed a ceiling;
− The special education allowance awarded to any person who is caring for a disabled child until
the 20th birthday;
− The maintenance allowance granted to the surviving spouse or parent or family home to raise
an orphaned child;
− The school allocation of available to children under 18 who continue their studies or placed
under apprenticeship provided that their income does not exceed 55% of SMIC;
− The lone parent allowance granted in case of insufficient resources to persons bearing the
burden alone of at least one child;
− The housing family allowance granted in case of housing insalubrity;
− The allocation of social housing in case of housing insalubrity to the elderly, the disabled,
some unemployed and beneficiaries of the RMI.
Family benefits are granted to any French or foreign person residing in France, with a dependent
child or children living in France under 20 (or 21 years for housing allowances to family and the
Family).
Old age
All the schemes of basic and supplementary pensions in France work on the method of
distribution. The schemes redistribute every year, in the form of pensions paid to retirees;
contributions received that year from the assets. If the rules of the various pension plans in France
correspond to different concepts, however they are based on common principles.
All schemes incorporate mechanisms of solidarity: solidarity between generations (principle of
distribution) and solidarity within a single generation (large redistributions between different
12. occupational groups and gender). These principles of solidarity occurs both in the regimes, between
the regimes and beyond regimes at the national level. There are transfers between the schemes, and
therefore solidarity between the basic schemes, as well as mechanisms for schemes coordination.
Solidarity at the national level consists of the minimum old-age pension assigned to all seniors who
have limited resources, paid by the solidarity fund retirement (which also pay some family benefits),
but also of state subsidies granted to certain regimes (farmers, SNCF, RATP, mining, marine), and
finally of various taxes allocated to pensions. The retirement system in France is organized into
three levels: a compulsory system, a scheme often mandatory, and optional arrangements.
Funding
Contributions
The French system of Social Security is financed largely by contributions based on the wages of
employees. However, new funding policies have sought to broaden the base by taking into account
all the household income while policies to promote employment led to lighten the burden of
contributions on low wages.
The income of social security schemes are traditionally divided along the following categories:
− The" actual contributions" (57% of total revenue) represent the contributions paid by the
insured and employers to social security.
− The "fictitious contributions" (8% of revenue) correspond in schemes employers in funding by
the employer of the scheme it manages. Indeed, the employer must ensure the balance of the
scheme.
− The "public contributions" (3% of revenue) represent direct payments to the state, including
grants to individual special regimes balance
− The "assigned taxes" (19% of revenue) include various contributions and taxes used to finance
social security. The most important is the general social contribution (CSG), based on all
household incomes and contributing to the financing of health insurance, family benefits and
Retirement Solidarity Fund.
Budget
13. The budget of the Social security system in France is separate from the budget of the state and is
subject to a separate vote and an act of parliament (loi de Finances de la securité Sociale). The 2010
budget amounted to 428 Billionn €.
Although the Social security system achieved surplus between 1999 and 2001, it has since been
repeatedly achieved important deficits, especially in 2009-2011 in the aftermath of the Great
Recession. The 2013 budget is forecast to reach 469 Billionn € and a deficit of 12.6 Billionn €.
Marisol Touraine, Minister of Social Affairs and Health, announced in September 2016 that the
Social Security budget would be balanced in 2017 for the first time in 16 years.
Spendin
g
Resource
s
Balanc
e
Health 153,4 141,8 -11,6
Pensions 102,3 93,4 -8,9
Family 52,9 50,2 -2,7
Workplace accidents 11,2 10,5 -0,7
Total (General regime) 311,5 287,5 -23,9
Total (All systems) 427,5 402,0 -25,5