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French workers are taking more sick leave than ever, but the government can’t afford to foot the bill

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Alex Ledsom
Alex Ledsom
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Alex Ledsom
Alex Ledsom
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October 10, 2024, 1:30 AM ET
In France, when someone is on sick leave, national health insurance kicks in on day four and pays 50% of their salary, assuming their salary is at most 1.8 times the minimum wage.
In France, when someone is on sick leave, national health insurance kicks in on day four and pays 50% of their salary, assuming their salary is at most 1.8 times the minimum wage.Getty Images
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French workers are taking more and more sick leave, and with the government facing unprecedented debt, it’s likely that new Prime Minister Michel Barnier might decide to cut back when his new budget is revealed this week.

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Les Echos reports that for the first six months of 2024, the cost of French workers taking sick leave increased by 8.5% compared to 2023.

France’s national health insurance, la Caisse nationale d’assurance-maladie (CNAM), predicted a €17 billion spending plan in 2024, but that figure has almost been spent. Stoppages for more than three months have risen by 9.5%, and sick leave due to work accidents is up by 11.3%. Shorter periods of sick leave are not as high but still make up almost half of the total amount–is France fast becoming the sick man of Europe?

Interestingly, inflation and demographics don’t fully explain the story. France has an aging workforce that gets larger every day, but between 2019 and 2023, this only accounted for 19% of daily sick leave figures. It costs to keep people off work so inflation also has a big impact, accounting for around 39% of the increase in cost since 2019.

So, we can do the math and inflation and demographics can’t explain the remaining 42% of costs. People are going on sick leave, and more are staying on sick leave for longer. Thomas Fatôme told Les Echos, general director of CNAM, that it could be that more people have chronic sickness or that people are taking advantage of the system. 

Since the pandemic, it is also true that mental health problems have risen alarmingly, particularly in the 18-24 year old age group where Le Monde reports that one in five young French people has a depressive disorder.

In France, when someone is on sick leave, national health insurance kicks in on day four and pays 50% of their salary, assuming their salary is at most 1.8 times the minimum wage.

The French government is heavily in the red. Le Monde reports that the country’s debt reached a record €3.228 trillion, 112% of GDP when the EU sets a maximum of 60%. Out of its European counterparts, only Greece and Italy have a higher debt-to-GDP ratio.

When Barnier delivers his draft budget this week, he needs to find a way to save €40 billion. Word is that he’s planning to lower this ceiling from 1.8 to 1.4 times the minimum wage, a plan that could save the government up to €600 million.

What would likely happen, though, is that employers would be forced to make up the shortfall currently provided by social security or insurance companies. Ultimately, this might lead to employers campaigning for a complete overhaul of the system in an attempt to combat the growing issues of absenteeism.

Employers could argue that it’s fairer for payments to kick in later so that workers would be less likely to decide to take days off. Some would like to see the system pushed further and make the social security benefits kick in on day seven instead of day three; this would save up to €950 million. Neither of these strategies though, would pass easily through the courts without a fight from employees and unions nationwide.

In the meantime, the government will likely crack down on the people who have been off work for more than 18 months (around 30-40,000 people) and investigate the 7,000 doctors prescribing this sort of long-term sick leave.

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