French President Emmanuel Macron on Tuesday unveiled plans to make France's health care system, considered one of the best in the world, more efficient and sustainable for the next 50 years.

Macron announced organizational changes at hospitals, in the recruitment of doctors, and better use of digital technologies to provide health care to patients across the country, regardless of where they live.

Macron said "a lot of our neighbors envy the excellence of our health care system. We are attached to our model which associated hospital medicine—public and private—and private medical practice."

Health care planning

There is a wide variety of health systems around the world, with as many histories and organizational structures as there are nations. Implicitly, nations must design and develop health systems by their needs and resources, although common elements in virtually all health systems are primary health care and public health measures. 

In some countries, health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious organizations, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve.

However, health care planning has been described as often evolutionary rather than revolutionary. France came out number 1 in a World Health Organization report comparing 191 countries in 2000.

A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health. This includes efforts to influence determinants of health as well as more direct health-improving activities.

A health system is, therefore, more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behavior change programmes; vector-control campaigns; health insurance organizations; occupational health and safety legislation.

It includes inter-sectoral action by health staff, for example, encouraging the ministry of education to promote female education, a well-known determinant of better health. But the country's health care system is struggling with increasing costs and lack of doctors in some rural region and poor neighborhoods.

One short-term measure consists in hiring 400 family doctors—paid by the state— in so-called "medical deserts." The current rule that sets quotas on the number of students in medicine, dentistry, the pharmacy will be abolished in 2020.

Hospitals will be classified into three categories: local health care, specialized care, and ultra-specialized care—each focusing on its priorities, to optimize patient care.