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The responsibility of the
healthcare system is taken at a national level. The budget is presented
annually, as well as the financing details for the healthcare system for the
following year. The ministry of health is responsible for the health policies,
overseas management of resources and is the one responsible for setting the
targets for the health care expenditure. Over the last decades, health care
expenditure in France rose rapidly in comparison with the economy as a whole.
More specifically, the gross domestic product (GDP) per capita is $38.000 and
the expenditure on health was 11.5% of GDP in 2014(WHO, 2017) in comparison
with 10.4% in 1995. Since 1996, there is in place one main resource allocation
mechanism ONDAM which controls the SHI expenditures in health care. Since 2010
ONDAM the cost-containment measures have been more intense and consequently the
targets have been underspent. France has been ranked by WHO third among
European countries for health care expenditure as a proportion of GDP (Chevreul
et al 2015).  The pooling of the funds
are arranged in a national level. The allocation of the national budges is
voted every year by the Parliament and it is allocated in 4 sections: the
public and non-profit hospitals, for-profit hospitals, out-of-hospital care and
geriatric care (The Commonwealth Fund, 2013) . The main body responsible for
collecting compulsory funds is the Union for the recovery of Social Security
Contributions and Family Allowances. All the revenue collection flows into a
single pool run by the Central Social Security Agency and then they are
allocated among different national branches like SHI; family allowance etc. Through
employees and employers contributions, as well as through specific taxation (e.g.
tobacco), taxes on pharmaceutical companies, General Social Contribution (CGS) the
revenue collection is achieved (Chevreul et al 2015). 

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