Private health care

[Logan]

I have been advised elsewhere on this forum that it is not possible to live in France and opt out of the state healthcare system and go 100% private. BUPA for example have tailor made contracts for European residents. Can anyone advise if this is correct? Seems a little draconian what happened to freedom of choice? It costs 8% of your gross income to be in the state system plus the cost of a 400% mutuelle. Going private competes on costs, is more flexible and less complicated.

[Coco]

Can you opt out of UK NI contributions then?  I ran a UK payroll for seven years and never came across any paperwork offering this option.

I paid NI in the UK for 27 years and my husband paid it for 29 years.  We've never needed more than one or two visits a year to a GP and the only time we ever wanted hospital treatment we were told that fertility treatment was not covered under the NHS.  That's life.   If everyone who could afford or chose to pay for 100% private health care or send their chldren to private schools chose to opt out of those parts of NI and income tax the country would be in even more chaos than it is.

You pay Council tax whether or not you use the local police or fire services, whether or not you use the local sports centre, swimming pool or library.  Shall I go on?

If you send your children to private school you don't get a rebate on income tax.

In fact I don't HAVE any children but I still paid the same amount as people with half a dozen - in fact MY income tax was paying for THEIR child benefit.  It's the way civilized societies work.

[Quillan]

[quote]I have been advised elsewhere on this forum that it is not possible to live in France and opt out of the state healthcare system and go 100% private. BUPA for example have tailor made contracts for Eu...[/quote]

Firstly it is correct that if you are a resident in France for more than 180 days you have to be a part of the French system. You can only (I think) get 100% private insurance if you are refused entry to the French system.

Secondly, I have been a memeber of BUPA for many years in the Uk and when I spoke to them about coming to France all they could ofer was the equivelent of a top-up insurance which was the same number as the cost of a French one but in pounds so it would have cost around 50% more.

The type of European cover (and international cover) offered to people is for workers, say computer consultants, who work via a UK company and travel the world working for 6 months in this country and six months in another etc etc. By all means speak to them (BUPA) but I don't think you will find what you are looking for. With regards to opting out of any state system I don't think you will find you can.

I appreciate you are retired and drawing a pension but you should have costed out your living expences in France before you came and included your health cover. The French health system is far better than in England (read the other post about French hospitals) but there is a price, and it's more than in the UK but then you pay for what you get. Perhaps the UK system would be better if they charged people more for their NI contributions and stopped treating people who arrive in the UK with no money and have never paid anything in (like France). Of course I appreciate the human rights issues but then for those that activly support them then let them pay more NI, another 10% to 15% perhaps should sort things out.

[Russethouse]

Apparently 'middle income groups' now lose over 50% of their income in tax in the UK - one way and another. National Insurance was fairly recently 'hiked' - a tax by any other name.

At least it has the effect of making France look competitive

[Teamedup]

Sounds like you have been advised correctly to me. If you come or want to come to France then you have to go by their laws and rules.

[Boiling a frog]

[quote]I have been advised elsewhere on this forum that it is not possible to live in France and opt out of the state healthcare system and go 100% private. BUPA for example have tailor made contracts for Eu...[/quote]

As others have said you cannot opt out of the UK NI so why think that you can opt out of the French system

You pay 8% of your income after deducting an allowance of approx 6000euros then you can either opt for top up insurance or not bother so there is a slight element of choice.

However if you are retired and of pensionable age then you are entitled to an E121 and you dont pay anything for your health care except for the top up insurance.

[Logan]

[quote]As others have said you cannot opt out of the UK NI so why think that you can opt out of the French system You pay 8% of your income after deducting an allowance of approx 6000euros then you can eith...[/quote]

If you are not employed in UK eg: retired, private income etc. Then you have a choice to either pay class C NI contributions or not. Entitlement to National Health Service treatment is based on residence only not contributions.It is perfectly possible to opt out of paying NI. Only your state pension will be effected.

I dislike the fact that in France you do not have a choice. I accept if it is the law then you have to comply but like all Frenchman I'm looking for a loophole!

[Mysfloss]

[quote]If you are not employed in UK eg: retired, private income etc. Then you have a choice to either pay class C NI contributions or not. Entitlement to National Health Service treatment is based on reside...[/quote]

I thinkthat you have a choice,play by the rules or return to the uk!Sounds harsh may be it is,but these rules are the same for everybody.

[Logan]

[quote]I thinkthat you have a choice,play by the rules or return to the uk!Sounds harsh may be it is,but these rules are the same for everybody.[/quote]

Thank you Mysfloss for your completely useless comment to this debate. I am seeking new ideas for a way to provide legal healthcare in France at a more economic cost. In my experience things are seldom black and white in France there are always shades of grey. The French know what they are. We Brits tend to accept the first thing we are told. Often I feel it's the last thing we are told which usually works best.

[Quillan]

[quote]If you are not employed in UK eg: retired, private income etc. Then you have a choice to either pay class C NI contributions or not. Entitlement to National Health Service treatment is based on reside...[/quote]

I don’t know where you are really coming from with these comments but to be honest if I read them as you have written them then you are either a) very stupid or b) very naïve or c) had some very bad advice or just didn’t do your homework.

 

Some weeks back I wrote a piece about some friends of ours that have tried to circumnavigate the French system but unfortunately one of them developed cancer which may prove fatal. They are being treated in a French hospital and now have a horrendous bill to pay which may result in the forced sale of their French home. It has already resulted in the confiscation of their UK passports by the gendarmes until the issue of payment for the treatment is resolved.

 

Your comment of “but like all Frenchman I'm looking for a loophole!” is really quite silly, nobody likes paying tax etc wherever they live but it’s a fact of life and as you have decided to live in France you pay their tax’s and social contributions and slighting the French won’t do you any favours either.

 

With regard to you now living and residing in France, you are now classed as resident because as you previously said you are paying social charges (by your own admittance). Therefore under current UK law you will be treated as a non resident in the UK and technically will have to pay for doctors etc (there was a post on the old forum about this some time back), my wife had to do this on a recent visit to the UK (£30 for a doctor).

 

This sort of attitude really makes me angry. So much information has been given on this forum about the French system and what you pay, most of it by people fare more qualified than I. You can’t beat the system so don’t even try and as far as your comments on freedom of choice is concerned you have one, pay up or go home if you don’t like it.

[Mysfloss]

[quote]I don’t know where you are really coming from with these comments but to be honest if I read them as you have written them then you are either a) very stupid or b) very naïve or c) had some very bad a...[/quote]

Thanks Quillan saved me replying to another poor pensioner on a fixed income

[letrangere]

If you've got the money and can prove to the authorities that you're paying for full private health insurance to cover any medical eventuality in France why shouldn't you be allowed to?  By the time you've paid 8% of your income and purchased top up insurance some people may be worse off than they would with a 100% full reimbursement private scheme.  M

[Miki]

[quote]If you've got the money and can prove to the authorities that you're paying for full private health insurance to cover any medical eventuality in France why shouldn't you be allowed to? By the time y...[/quote]

Margaret,

I think the main point here is that the French changed some rules relating to health, a little while back. One was to bring in CMU and around the same time banned private healthcare from giving full cover to residents of France. Now those companies can offer "top ups" but they cannot sell policies that can be used instead of regime obligatoire for residents here in France. I think that is right, maybe Peter Owen will put that straight?

Anyway, the point being, that everyone should pay in, to what amount they can. If everyone was to wish do it as you say M, then who will pay the hospitals whilst waiting for you to appear for an Op or whatever?

It is pretty important for any health system to work that ALL persons able to do so, should pay something in to the system. Private systems can only work really if it is tandem with the system as a whole. If the service itself receives no funds, then there is no health system, unless you include the few hospitals that run on private money and they are pretty expensive and have no want of the poorer off.

 

 

[Logan]

I would like to thank those contributors to this thread who have made some interesting and constructive posts. I ignore the disingenuous attitudes of a couple who seem unable to grasp my point.

Leaving the state system in France seems not to be an option. The costs of healthcare public or private are fairly similar when I compare my quotes from private organisations. There is therefore little financial incentive to not be part of the system. However being in the system here does disqualify you from the NHS in UK apart from emergency treatment by form E111 and that is a consideration.Unfortunately there is no legal halfway house.

[BJSLIV]

I don't see how being a member of the French sytem disqualifies you from treatment in the UK , any more than being a member of the NHS disqualifies you from treatment in France.

You pay into the system of the country in which you live , and emergency service is available under E111 rules in other EU countries that you may visit.

If you are living and paying into the French system, you don't need  cover for  routine treatment in the UK. When you move back to the UK, you will rejoin the NHS as if you had never left.

 

[Logan]

[quote]I don't see how being a member of the French sytem disqualifies you from treatment in the UK , any more than being a member of the NHS disqualifies you from treatment in France. You pay into the sys...[/quote]

The problem is if you often move between countries and stay for a few months in each then routine treatment is not allowed under the current rules. You need to have private insurance and that takes us back to the original subject. I appreciate that most folk may not live that. However if you do try to stay within the rules in theory you will need private for the UK and be in the French system as well. I would just like to pay for one and be covered in both. Not possible.

[Boiling a frog]

In an ideal world maybe everyone in the world would be entitled to free health care anywhere in the world but this is not an ideal world

I dont see the great difficulty you are resident in France you pay into the French system  go to any other country in the EU you get emergency treatment by the rules of that country it just so happens that in the UK it is free.If you want routine medical treatment you come back to France for it. Its the same rules for everyone in the European Union  

[Redcap]

"The problem is if you often move between countries and stay for a few months in each then routine treatment is not allowed under the current rules. "

But then you need to look at the rules regarding residency/domicile, if you are doing as you say skipping from one country to the other, you will need to be resident in one of them, and therefore pay into that countries system. That's how it seems to me.

Face it, if you are living in France and want to be legal etc, unless you have e121 or 106, then you cough up the 8%!

Regards,

Bob

[Logan]

[quote]In an ideal world maybe everyone in the world would be entitled to free health care anywhere in the world but this is not an ideal world I dont see the great difficulty you are resident in France yo...[/quote]

I am not personalising this. I am highlighting a flaw in the rules because France will not allow a resident to opt out of the state healthcare system and go private. A one size to fit all does not work. Is this not often the case in France and one of the irritations we have to live with? If you move between these two countries (France & UK) or France and anywhere else, it is not possible to remain within the law and get healthcare as a routine in another state.(Emergencies accepted).The French system does not allow for it. As an example:- Spain and UK is different. There is no bar on opting out of the state system. You can go private very economically and keep your NHS status in UK. All routine medical care is covered and then emergencies by E111. Why does France not do the same? This is my point and part of the subject of the thread.

[BJSLIV]

I think there are probably a number of reasons why the French system operates as it does. Firstly the private and state systems are so closely interlinked that you never really "Go Private" in the UK sense. When you are treated in a private hospital the state system still pays part of the bill.

Secondly the funding of the French state system is much more segregated from the rest of government spend. Hence all the talk about the health deficit. Because of this there less opportunity for cross-subsidy as in the UK, where you don't opt out of paying for healthcare when you go for "Reduced Stamps" because you are still paying through direct and indirect taxation.

Thirdly I suppose the concept of Egalite and Fraternite come into the reckoning; Everyone in the same scheme, and sharing the burden with the less favoured. It was to put a stop to people dodging their civic responsibilties that 100% private healthcare was banned, save in a few specific cases.

As far as Logan's specific case is concerned, I can see that superficially there may be an attraction in having full healthcare available wherever one happens to be, but I still think that one would want to have non-emergency treatment where you live, and if that is France then have your routine treatment in France.

[Jackie]

My word you do seem to have pushed a few buttons with this one. Look cutting through all the aggression from other members I would say this. I had PPP cover in the UK, went with the job, and the care and treatment I and my wife have had in France is miles better in some cases or as good in others as anything we have experienced in the UK. So find a good mutuelle and you should be fine. I doubt that full medical cover, if you had it, is going to be in fact any better than what is now available to everyone in France. It just takes a little getting used to but it seems to work!................John in 79 

[Miki]

Spain and UK is different. There is no bar on opting out of the state system. You can go private very economically and keep your NHS status in UK. All routine medical care is covered and then emergencies by E111. Why does France not do the same? This is my point and part of the subject of the thread.  Logan

I don't fully understand?

If you live away from the UK, in Spain or wherever and you tell the UK of your change of country residence, your health rights in the UK change. So although you can go private anywhere in the world, your rights to normal NHS rights are not the same. Have I read your reply right?

The E111 is a European card of course, so can be used in any EEC country for the purpose it was designed for but I really don't get what you are talking about, sorry. Are you saying that a private health insurance taken out in Spain will cover you in the UK but emergencies are on the E111?

Can you enlighten me?

 

[Teamedup]

I don't understand either.

One opts out in the UK, but has health care, which all the mugs pay into, which then generously dishes out E111's for those who are travelling abroad who haven't paid into the system in the first place......... is that it?!

[opas]

And don`t forget that when you decide to go to Uk as a` Health Tourist` in a NHS hospital (non emergency) and read all the signs that state you are a UK resident and sign the forms to declare the same.......well don`t come running back to france with your tail between your legs expecting sympathy.....seems to me you want the best of both worlds, and as my dad always says `its either or either`

[Boiling a frog]

[quote]I am not personalising this. I am highlighting a flaw in the rules because France will not allow a resident to opt out of the state healthcare system and go private. A one size to fit all does not wo...[/quote]

We would all wish to have our cake and eat it

Re Spain

Spain has a free health system open to a few people with low income otherwise you pay via private medical insurance.

If you are a UK national who moves to spain then you are no longer entitled to the benefits of the UK national health system

To ensure that you receive an adequate standard of care in spain it is neccessary to take out private medical insurance as the spanish free system has long waiting lists etc.

Therefore you are totallly wrong in this post unless of course you do not tell the UK authorities that you have moved to Spain and pretend that you are still residing in the Uk.The UK authorities have tightened up on this loophole recently and you will no longer be entitled to UK routine health care if you reside in another eu country