• G Delbecchi, C Jollet, F Fleury, A Fontaine, and A Veisse.
• Hôpital de Bicêtre, le Kremlin-Bicêtre.
• Presse Med. 1999 Jun 5; 28 (20): 1075-9.

AbstractTheoretically, since 1992, 100% of socially underprivileged persons residing in France have unlimited access to health care. However, before they become fully integrated into the society, many refugees in various legal situations do not have access to health care. The mechanisms behind this exclusion unmask the difficulties the health care system has in managing the underprivileged population. This work was conducted at the Comede health care facility specially designed to care for refugees. According to the current French legislation, health care protection and medical insurance coverage is a right of all persons living in France. Although the establishment of a large number of centers specifically designated for the underprivileged population has improved access to health care, repeat visits and uninterrupted care cannot be assured unless the patient has been awarded 100% free health care status. There are several obstacles to acquiring this status: complexity of the legal procedures, recipients unaware of their rights and the procedures of the health care system, information limited to specialized journals, restrictive or illegal action by the health protection services. All of these obstacles can be overcome if the patients are given precise information, notably by their physician. Instead of effectively applying the procedures concerning patients rights to health care, the system has developed free health care facilities which do not necessarily provide uninterrupted care. To provide the universal health care coverage promised by the legislators, the only criteria for access to care must be residence in France. Acquiring this status should be considerably simplified and requires the active participation of the entire health care community.

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