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Yet France's finance minister, Eric Lombard, says he now needs to find 40 billion euros of overall public-sector savings, some of it from health, to curb the country's deficit to a still-hefty 4.6% of GDP in 2026.
然而，法國財政部長埃里克·朗伯德表示，他目前需要籌集400億歐元的公共部門總體儲蓄資金，其中部分將來自醫療領域，以期在2026年將該國財政赤字控制在仍高達GDP4.6%的水平。
This new pressure comes at a time when the health system already faces a triple squeeze.
這一新壓力出現之際，醫療體系已面臨三重擠壓。
The first is due to a shortage of younger doctors. For decades the government capped the number of medical students.
首先是年輕醫生的短缺。幾十年來，政府一直限制醫學院學生的數量。
President Emmanuel Macron abolished the rule in 2019. But it will take a decade for numbers to recover.
總統埃馬紐埃爾·馬克龍于2019年廢除了這項規定。但醫生數量的恢復還需要十年時間。
Nearly a third of GPs in France are aged over 60. Retiring GPs struggle to find younger doctors to take over their surgeries.
法國近三分之一的全科醫生年齡超過60歲。退休的全科醫生很難找到更年輕的醫生來接手診所。
A GP near Paris, aged 70, says he returned from retirement to consult part-time to help patients.
巴黎附近一位70歲的全科醫生表示，他退休后重返工作崗位，兼職為患者提供咨詢服務。
This shortage has exacerbated a second problem: overloaded hospital emergency services.
醫生短缺加劇了第二個問題：醫院急診服務超負荷。
France has more hospital beds and intensive-care beds per person than the OECD average.
法國的人均醫院床位和重癥監護病床數量高于經合組織的平均水平。
But in recent years it has been closing beds, as part of a strategy to rationalise hospitals and shift the focus to day surgery.
但近年來法國一直在縮減醫院床位，這是優化醫院資源配置、將重心轉向日間手術的戰略之一。
Yet the number of patients turning up at emergency services has soared.
然而，到急診就診的患者數量卻飆升。
Between 1996 and 2023 the yearly number of visits to accident and emergency doubled, from 10.1 million to 20.9 million.
1996年至2023年間，每年急診就診人數翻了一番，從1010萬人次增至2090萬人次。
Moreover, 72% were "not very serious or urgent", noted a report by the Cour des Comptes, the national auditor, in 2024.
此外，法國審計法院在2024年的一份報告中指出，72%的病例“并非非常嚴重或緊急”。
Some hospital doctors have gone on strike in protest. In February emergency doctors at Perpignan public hospital denounced an overload that was "more than critical", saying that they could no longer staff shifts fully.
一些醫院的醫生已經罷工抗議。今年2月，佩皮尼昂公立醫院的急診醫生譴責“超過臨界值”的超負荷運轉，稱他們已無法為所有輪班配齊人員。
A third difficulty is "medical deserts". Doctors tend to choose to live in big cities, cobbled towns and coastal resorts, leaving the rural interior without decent cover.
第三個難題是“醫療荒漠”。醫生們往往選擇居住在大城市、鵝卵石鋪就的城鎮和海濱度假勝地，而內陸農村地區則缺乏合適的醫療保障。
Waiting times to see an ophthalmologist, for instance, vary from six days in some areas to 123 days in others, according to a Senate report in 2024.
例如，根據參議院2024年的一份報告，眼科醫生的候診時間因地區而異，短則6天，長則可達123天。
The government is offering sign-up bonuses to encourage doctors to move to unpopular areas.
政府正在提供簽約獎金，以鼓勵醫生遷往不受歡迎的地區。
Some village mayors and big public hospitals, including one in a rough neighbourhood of Marseille, have provided surgery premises to lure GPs. But France's patchy medical geography is proving hard to shift.
一些村長和大型公立醫院，包括馬賽一個治安較差社區的醫院，都提供了手術場所來吸引全科醫生。但法國參差不齊的醫療資源分布狀況難以改變。
Mindful of these problems, the government is trying to ease the pressures, as well as to cut waste.
意識到這些問題后，政府正在努力緩解壓力，并減少浪費。
Catherine Vautrin, the health minister, has just tightened the rules, for instance, on prescriptions for reimbursed sticking plasters, in order to save on the 740 million euros it spends a year merely on this.
例如，衛生部長凱瑟琳·沃特林剛剛收緊了可報銷創可貼的處方規定，以節省政府每年僅在這一項上就花費的7.4億歐元。
But such sums are trifling next to the overall health budget. Old habits are resistant.
但與整體醫療預算相比，這些錢微不足道。舊習難改。
The French remain enthusiastic pill-poppers; their doctors still prescribe more antibiotics than those elsewhere.
法國人仍然熱衷于服用藥物；醫生開出的抗生素處方仍然比其他地方的多。
France, notes the Cour des Comptes sternly, "is one of the last OECD countries to reimburse thermal spa treatments with no medical benefit proven"—and this to the tune of 250 million euros in 2023.
法國審計法院嚴厲指出，“法國是經合組織中為數不多的仍為未經證實醫療效果的溫泉療法提供報銷的國家之一”，2023年報銷金額高達2.5億歐元。
In some ways France's health system is a victim of its success.
從某種程度上來說，法國的醫療體系是其成功的犧牲品。
"Because of the very good historical indicators, and the sense that France has been one of the best health systems in the world, these new pressures come as a shock," says Francesca Colombo, head of the OECD's health division.
“由于歷史數據表現非常出色，加之法國一直被視為擁有全球最完善的醫療體系之一，這些新的壓力令人震驚，”經合組織衛生部門負責人弗朗西斯卡·科倫坡表示。
Accustomed to excellence, the country expects it—and is ill-prepared for the upcoming budget squeeze on waste and excess that is needed to keep it that way.
法國已經習慣了追求卓越，也期待著卓越——卻對即將到來的預算緊縮毫無準備，而削減浪費與過度開支正是維持卓越的必要手段。
