France All the healthcare is overlooked by government France scores highly on GP numbers and on spending as a percentage of GDP The majority of patients must pay the doctor or practitioner upfront. The patient has freedom to choose which doctor or service to visit. All health transactions Centre on a smartcard, the Carte Vitale. The Carte Vitale is swiped and the money is paid back into the patient’s bank account within five days. In general, the state refund rate is between 70% and 100%. The poorest people and the long-term sick are covered 100%. A large number of prescribed medicines are reimbursed between 15% and 100%.