2023-05-31 15:40:33
The plan to combat benefit fraud was unveiled in an interview with social security minister Gabriel Attal in French daily Le Parisien. The interview covered only the broad outline of the plan, so there are many questions still unanswered.
In among plans to restrict access to social benefits such as unemployment benefits and family payments to people who spend a significant part of the year outside France was a proposal about the vital card health card.
Attal said: “I want to move gradually towards merging the vital card card and the identity card into a single secure card, as is the case in Belgium, Portugal and Sweden. This is both a simplification measure and an additional guarantee of the individual’s identity and associated rights.”
He added: “The issue now is vital cards used for illegal medical tourism. People coming to France and using someone else’s vital card for treatment.”
Over the last five years, 2.3 million vital cards have been deactivated because they were “surplus”, according to Attal.
So why is this a problem for foreigners living in France?
The vital card is the card that proves that you are registered in the French health system, when accessing treatment, you present your card and a certain percent of the cost of your appointment or prescription is reimbursed by the French state.
READ ALSO How the carte vitale works and how to get one
Anyone who has been living full time in France for more than three months is entitled to a vital card – there is no need to be a French citizen – and the vast majority of foreigners living in France have the card, and use it to access healthcare.
The French ID card, on the other hand, is only available to French citizens – including foreigners who have been naturalised as French. It is carried by virtually all French people (although it is not compulsory) and acts as a combined proof of ID, proof of French citizenship and travel document (if you are travelling within the EU).
There are, therefore, many thousands of people who are legally resident in France and who have a vital cardbut do not have a French ID card.
It is possible to access healthcare in France without a vital card – but it means that the state will not reimburse the cost. Patients must therefore pay out of pocket or rely on private health insurance, which is unaffordable for many.
READ ALSO How France’s public healthcare system works
So what will happen to foreigners with no French ID?
As we mentioned, this plan is in the very early stages at the moment. The vital card aspect was just one part of a wide-ranging interview that provided very little in the way of concrete detail.
Any change to this system would have to be drafted into a bill, presented to parliament and passed into law. It would also have to go through several checks from regulatory bodies – including a review by France’s data protection authority, CNIL, in order to determine whether it will be legal to combine identity data with health data, as well as how to make such a combination card secure.
People who are legally living and working in France are entitled to register in the healthcare system, while the Brexit Withdrawal Agreement also guaranteed healthcare for Brits who were living in France before 2011.
In short, French authorities would have would have to introduce some kind of different system for foreign vital card holders, otherwise it would, in effect, amount to stripping them of their rights.
Le Parisien itself noted that “there are still several questions outstanding” around this plan, particularly for the many foreign residents who benefit from a vital cardbut do not hold a French ID card as well as for those French nationals who also do not have the ID card, because it is not technically mandatory.
The French data protection watchdog CNIL has stated in response to the idea that the government “must ensure that alternatives to the use of identity cards are maintained”.
Attal has not given any details as to how those questions would be answered but The Local has asked the finance ministry to clarify the situation for foreign residents in France.
Waiting times
On top of the legal and political hurdles is a practical one – waiting times for a new vital card are already very long, and reissuing the cards to all of France’s roughly 67 million residents is an enormous task.
Pressed on this, Attal said: “I’m launching a preconfiguration mission to determine the timetable and procedures. Obviously, this project cannot be envisaged until card production times return to normal! We need an ambitious and credible timetable.”
A proposal to create a biometric vital card – under the same conditions as the current card but with added security measures such fingerprints – was made last year, at an estimated cost of €250 million.
It has run into opposition both on cost and practicality grounds, with many doctors also opposed to it as risking excluding the elderly and other vulnerable groups from healthcare.
Attal said that a recent report recommends scrapping the idea, although no final decision has been made.
The Local has asked the finance ministry to clarify the situation for foreigners in France
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