France's General Social Affairs inspectorate and Finance Inspectorate have issued a report on state medical assistance (SMA).
Introduced in 1999, SMA aims to ensure access to healthcare for patients who are not eligible for health insurance or for universal medical coverage (UMC), in particular illegal immigrants.
According to the official report, 192,000 people benefited from SMA in 2006, which is fewer than the number eligible. The report shows that health expenditures for people dependent on SMA is higher than that of health insurance beneficiaries. This is due to the high level of hospital costs, because these patients have difficulty accessing primary healthcare.
The report concludes that the SMA system does not encourage fraud and that the expenditure is justified. It favours extending coverage to children, and recommends against restricting the treatments covered.
Contrary to generally accepted thinking, this official report defends SMA both for humanitarian reasons and in the interests of public health and good governance of public resources.
At a time when France expels sick foreigners to countries where they will not be able to receive the care they need, the report on SMA comes to the aid of healthcare professionals who are trying to assist this particularly vulnerable population.
©Prescrire November 2007
Source:
"AME : des dépenses justifiées" Rev Prescrire 2007 ; 27 (289) : 857
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