France's ongoing National Health Strategy has to an extent been superseded in importance by the necessity of dealing with the COVID-19 pandemic.
In April 2020, healthcare establishments dealing with the pandemic received additional government funding. To supplement this, an exceptional COVID-19 contribution on medical insurance contracts (contracts providing daily indemnities are exempt) is payable by insurers for 2020 and 2021.
Insurers have also taken a series of voluntary measures to assist the populations and businesses most at risk, including contribution to a government solidarity fund and insurance for medical staff. The French insurance association FFA members are committed to paying sickness benefits for up to 21 days for pregnant women and those with long-term health conditions certified as unfit to work. They also set up a global investment programme targeted to support micro-enterprises, SMEs and the health sector.
The investment programme, "Assureurs - Caisse des Depots Relance Durable France", aims to promote a sustainable economic recovery and will see an investment of EUR 2.2bn of which EUR 2bn will come from insurers. The health component of the private investment programme has seen a EUR 780mn investment from 19 insurers and three institutional investors go towards research, infrastructure, logistics and health services. Three funds are established, dedicated to the health sector.
The pandemic significantly impacted the health sector, with networks of providers within the mutual, provident, and insurance systems needing to adapt to treat COVID-19 patients, develop new services, and undertake social action initiatives, such as maintaining support for the vulnerable.
During the first wave of the pandemic (March to May 2020), there was a reduction in the consumption of medical services, reducing insurers' reimbursement costs. Non-urgent operations and surgical procedures were deferred, and beds used for COVID-19 patients. From June to December 2020, medical consumption increased, accelerated by demand for dental, optical and audiology services brought about by the 100% health reform. Increased demand could be seen for private rooms, with an increase in hospital fees and significant inflation in consultants' fees and accommodation costs. Conversely, some reduction in pharmaceutical costs were noted, following a drop in seasonal infections such as flu and gastroenteritis and the cost of COVID-19 testing met through the public system. For group medical insurances, there has been an increased utilisation of the portability option from a group plan to an individual plan due to company closures and lay-offs, which may increase at the end of 2021 and during 2020 with the end of state support.
Further, since 1 December 2020, policyholders have the option to terminate complimentary medical insurance contracts that last at least one year without fee or penalty, where the contract is unsuitable, too expensive, or a better option is available in the market. This is likely to increase costs for medical insurers.
The pandemic is thought to have reduced the health of France's population overall, with the postponement of surgeries and medical interventions such as those for cancer. An increase in costs and the number of procedures needed in the future is likely. Mental health has also been affected by isolation in lockdowns.
The COVID-19 pandemic has also increased medical teleconsultations. According to a survey by Argus de l'Assurance and Cegedim Insurance Solutions, whilst the public system had supported less than 100,000 remote consultations in 2019, it reimbursed more than ten times this number of consultations at the height of the first confinement in 2020. Before 2020, only 8% of the population had used teleconsultations, whilst by the end of 2020, this had risen to 24%. Whilst popular with those under 45, most people lack confidence in the technology, and there have been difficulties integrating it with France's health card (carte vitale).
The health component of the private investment programme has seen a EUR 780mn investment from 19 insurers and three institutional investors go towards research, infrastructure, logistics and health services.