Social Security in France

DOIhttp://doi.org/10.1111/j.1467-9299.1954.tb01723.x
Date01 March 1954
Published date01 March 1954
AuthorBARBARA RODGERS
Social Security
in
France
PART
11
By BARBARA
RODGERS
,\frs.
Rodgers completes
her
survey
of
the French Social Security system
riirh an account
of
the Public Assistance service and an appraisal
of
the
interesting method
of
co-ordinating the various welfare services.
PUBLIC
assistance has as long and complicated a history in France as in
our
own country, but it is only necessary to indicate some of the main features
of
its
development in recent years. Of these perhaps the most important
has
been the tendency to develop assistance as of right to certain categories
of
persons. This was in keeping with a principle which the revolutionaries
of
1789 sought to establish.
"
L'assistance n'a
btb
jusqu'ici regardbe que comme
un
bienfait, elle est
un
devoir
".l
But the
assistances obligatoires
(statutory assis-
tance) were not introduced until the end of the last and beginning of this
century
:
the main dates being free medical assistance in 1893, assistance to
children in 1904, to the old, the infirm and the incurable in 1905, to pregnant
women and to large families in 1913. More have been added since and now
most needy persons fall into one category or another. For the rest the
comiizunes
have a permissive power, enabling them to give temporary, supple-
mentary or emergency relief
(assistance facultative)
to residual cases as they see
fit.
Assistance may be given in cash or in kind. One of the most important
forms of statutory assistance-free medical assistance-is purely an assistance
in kind. Assistance for the aged may consist, in the words of our old
Poor
Law,
of indoor or outdoor relief.
There has been a steady movement away from the idea that public
assistance is for the indigent only. Even in the 19th century many of the
institutions, such as the hospitals and homes run by the public assistance
authorities, provided for paying as well as non paying patients. And more
recently, in order to help those with small fixed incomes who were not covered
by
the new social insurance schemes and were badly hit by the rise in the cost
Qf living, the State has recognised a new class of persons entitled to special
assistance-the
e'conomiquement faibles.
The increasing coverage of the social insurance and family allowance
schemes is gradually reducing the numbers of those
in
need, but public
assistance has still an important role to play, particularly in the care of
old
people, of homeless children, and in the provision of medical services.
It
must be remembered that as yet barely
60
per cent.
of
the population are
covered
for
medical benefits undcr the
insurance scheme, and
the
insurance
pension and assistance
to
retired workers are again only for the insured
classes.
'La
Rochefoucauld
Liancourt
in
a
report
to
the
Constituent
Assembly,
30th
May,
99
1790.
PUBLIC
ADMINISTRATION
Administration
A Decree Law of 1935 consolidated previous assistance legislation,
introduced a common means test for all forms of statutory assistance and made
the
dbpartement
responsible for their administration. Both the State and the
Commune
are however wholly responsible for certain services and each makes
a
contribution towards the
ddpartemental
ones. There are also of course the
complications introduced by the French law of settlement. They result in an
extremely intricate pattern of cross payments between
ddpartement
and
ddpartement
and State and
ddpartement,
but at least everyone has a settlement
in
a
ddpartement
or the State.
It
will be simplest to describe the actual services
by
dealing with each of these authorities in turn.
The Central Authority
The central authority is the Ministry of Health and Population. In
addition to its supervisory duties and to the substantial financial contribution
(varying from 78.78 per cent. in the Landes to 26.79 per cent. in the Alpes-
Maritimes2) which it makes to the
ddpartemental
services,
it
finances entirely
a
few specialised institutions (for example the National Institution for the
Deaf and Dumb), and three special forms of assistance
:
(a)
Military allowances for necessitous serving men’s families
;
(b)
Aide
aux
Economiquement faibles,
which takes two forms
:
(i) A Social Card
(carte sociule)
which entitles its holder to
certain benefits, namely, free medical assistance, free legal aid, the
reduction of one return railway journey a year which is granted to
all
those entitled to holidays with pay, and the Special Rent Allowance
(described below). To be entitled to a Social Card one must either
be in receipt of the statutory assistance for the old, infirm or incurable,
or be over
65
(or if unfit for work over
60)
and have an annual income
of less than 104,000 francs (138,000 if married).
(ii)
A
Temporary Allowance of 28,200 francs a year for those
whose total income including the allowance does not exceed the
income limits for the Social Card. This allowance, first introduced
in 1946 and frequently changed, is regarded as a purely temporary
measure to meet the needs of the many old people not covered by the
insurance pension or the allowance for retired workers, and to
supplement the very inadequate statutory old age assistance.
(c)
Since 1948
a
Special Rent Allowance has been granted to the
thmomiquement faibles,
to compensate them for the rent increases permitted
in
that year. Besides the holders
of
the Social Card, others whose
resources are less than the basic wage upon which family allowances are
calculated can be granted this special form of assistance.
2M.
An&&
Laporte.
L’Assistance Publique et Pride en France,
January, 1952,
p.10.
100

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