Abstract
The current French long-term care security system is an incomplete set of measures that is an interim result of various experimental phases. For some time now, the debate around an independent social security branch has also included the search for possibilities to offer protection against the risk of long-term care dependency by forms of security governed by private law. Thus, the creation of an independent risk category has, at least, been put to the test. This is also why, in order to understand the overall system, the temporarily discussed issue of a potential private insurance is to be taken into account. This solution is given little chance, however, mainly for financial reasons. Former president Sarkozy who, during his election campaign in 2007, showed a keen interest in introducing long-term care insurance, did not pursue this project in his actual term of office. After the election of François Hollande the issue of protection against the risk of long-term care dependency came to the fore again, and in 2014 a reform of the protection against the risk of long-term care dependency was to be carried out. Indeed, such a reform is in progress and at a relatively advanced stage due to the preparation of a draft proposal by the council of ministers; however, only a part of the measures aiming at protection against the risk of long-term care dependency is intended for reform (see below).
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Notes
- 1.
Vasselle (2011).
- 2.
Dossiers solidarité et santé, n° 49, 2013.
- 3.
On the commented translation of technical terms in the security system see Kaufmann (2004).
- 4.
Action sociale, which is executed by the various funds of all insurance branches, is of significance in all areas of social security and also benefits elderly persons. An action sociale in terms of a field of responsibility of the various social security institutions is executed, for example, if social measures are planned and carried out in particular areas of social security that are not yet institutionalised to the extent that fulfilment of a relevant requirement would automatically constitute a legal right. Action sociale is, possibly, the most adequate instrument for the realisation of new social protection mechanisms. Especially since it is not subject to any particular constraints, especially of an institutional nature, it can open up “testing grounds” (services, facilities, benefits in cash or kind, welfare in general) and potentially prepare a later institutionalisation of the service branch or, respectively, form of service thus created. Apart from the social security funds or, respectively, social security providers that run a semi-public action sociale, it is also the territorial entities, and the French departments in particular, that tend to effect a public action sociale. Both areas are supplemented by a private action sociale, which is mainly carried out by associations, especially welfare organisations (associations). Particularly with a view to the living conditions of elderly persons, action sociale is an essential field of activity of the French departments.
- 5.
Rapport Laroque (1962) sur la politique de vieillesse.
- 6.
Rapport Braun and Stourm (1988).
- 7.
Rapport Schoepflin (1991).
- 8.
Rapport Schoepflin (1991).
- 9.
Act No. 75-534 of 30 June 1975, OJ 30.6./1.7.1975.
- 10.
Igl (1987).
- 11.
Kaufmann (1996), p. 325.
- 12.
- 13.
Art. L. 232-1 CASF (Code de l’action sociale et des familles, Code of Social Action and the families).
- 14.
Act 2001-647 of 20 July 2001, OJ (Official Journal) 21 July.
- 15.
- 16.
Supplementary co-payment after balance of medical bills (ticket modérateur). It is the difference between the tariffs agreed on by the health funds and service providers and the amount assumed by social insurance (Art. L. 322-2 CSS, Social Security Code). Introduced in the 1930s, the aim had from the outset been to reduce the use of medical services to the necessary minimum.
- 17.
Kaufmann (1998), p. 151.
- 18.
Art. L. 232-2 CASF.
- 19.
Art. R. 232-1 CASF.
- 20.
- 21.
D. n° 2008-821, 21.8.2008, OJ. 23.8.
- 22.
Alternatives Economiques, No. 085, April 2010.
- 23.
Art. R. 232-4 CASF.
- 24.
The APA service is not identical with the purely medical services that are usually covered by the health insurance.
- 25.
Act No 2015-1776 of 28 December 2015.
- 26.
Art. R. 232-8 CASF.
- 27.
Art. L. R. 232-8 C. T. (code du travail, Labour Code).
- 28.
Art. R. 232-12; R. 232-13 CASF.
- 29.
Art. L. 7232-1 ff. C. T.
- 30.
Art. R. 232-14 CASF.
- 31.
Art. L. 355-1 CSS.
- 32.
Art. R. 322-10 CASF.
- 33.
0.67 times the benefit for permanent assistance from a third person.
- 34.
Art. L. 232-7 CASF.
- 35.
Art. L. 232-8 CASF.
- 36.
Art. L. 313-12 CASF.
- 37.
Decree n° 2004-1274 of 26 November 2004, OJ 27 Nov.
- 38.
See also below.
- 39.
It is to note that social Protection can be compulsory (protection provided by the Social Security is in all cases compulsory) or provided by volunteer measures. Social Protection other than This of the compulsory Social Security can be compulsory but has not to be so.
- 40.
Law No. 78-11 of 4 January 1978, Official Bulletin (Journal officiel, OJ 5 January 1978) in its version as an amendment act to the Social Act of 1975.
- 41.
Decree No. 180-448 of 8 May 1981, (9.8.1981); circular No. 81-8 of 1 October 1981, B.O. affaires sociales (BOAS), fascicules spéciales No. 81/43.
- 42.
Art. 6 of Decree No. 81-448 of 8 May 1981.
- 43.
Art. 1 Decree of 8 May 1981.
- 44.
Law 70-1318 of 31 December 1970.
- 45.
Law 79-1140 of 29 December 1979.
- 46.
Circular CNAMTS No. 207 of 29 October 1974.
- 47.
Circular No. 81-15 of 29 June 1989, Bulletin Officiel des affaires sociales (BOAS) n° 81/28, 11.8.1981.
- 48.
See also Dauchez (1988), p. 51.
- 49.
Art. L. 14-10-1 CASF.
- 50.
Law No. 2004-626 of 30 June 2004, OJ 1 July; Art. L 1410-1, I CASF, Law No. 2005-102 of 11 February 2005.
- 51.
Art. R. 232-19 CASF.
- 52.
Etudes et résultats n° 780, October 2011, 4.
- 53.
Etudes et résultats 780, 2011, 2f.
- 54.
Frinault (2005), p. 612.
- 55.
Gaulon (2011). It is a fundamental distinction which should, however, not make a big difference since in most cases long-term care dependency becomes a relevant topic only later in life.
- 56.
Projet de loi relatif à l’adaptation de la société au vieillissement, (law project concerning the aging of people). The correspondent for this project, Martine Pinville, submitted Report No. 2155 in July 2014.
- 57.
AEF Dépêche n° 5014194. June 2015.
- 58.
Law No. 2015-1776 of 28 December 2015 concerning the adjustments of society to the general ageing process (l’adaptation de la société au vieillissement).
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Kaufmann, O. (2018). Long-Term Care Benefits under the French Social Protection System. In: Becker, U., Reinhard, HJ. (eds) Long-Term Care in Europe. Springer, Cham. https://doi.org/10.1007/978-3-319-70081-6_4
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