France, like everywhere else, protects its nationals abroad… But that’s also true at home, every single day. And we tend to forget it.
Take health spending.
The French consumed €235bn of medical care and goods in 202213, or 9% of GDP (€207bn in 2019, €210bn in 2020, €226bn in 2021), including:
Hospitals alone run a deficit (after public funding) of €500M to €1,000M a year.
In 2023, our ONDAM (a fancy acronym for “national target for health insurance spending”, the cap France sets each year on public health spending) was €244bn, or €4,600 per person.14
That’s what the State agrees to pay for our health.
It’s fairly abstract, and above all, not very revealing about the real cost we put on life.
Let’s take clearer numbers.
According to estimates, annual deaths follow the same order:
Tobacco is a particularly interesting example. A 2020 poll found that 56% of French people thought tobacco brings in more than it costs.18 A misconception mainly fuelled by the intense media coverage of every tax rise.
Yet tobacco, excluding social cost19:
So you might expect the resources deployed to fight drugs to be 160x smaller than those spent on tobacco.
In 1997, the cost of anti-drug enforcement on the police side was estimated at €1.03bn20. A figure that has surely risen a lot in 30 years, though no one can say by how much. And it leaves out the judicial side (courts, prisons, rehabilitation officers and so on).
And yet the only proven direct effect is a drastic rise in prices.21
Tobacco taxes, on the other hand, like most taxes, work. Every study, in France and abroad, shows a direct link between higher taxation and lower consumption.22
A simple rule of three puts the break-even price of a pack at between €40 and €50. But how many people would be willing to pay for their own risk from drinking or smoking? Better still, if we ran a poll, how many non-smokers would be comfortable with society paying for the care of people who chose to smoke?
The same reasoning could apply to quite a few subjects.
How many would think it normal for society as a whole to pay the €10.6bn a year that obesity costs, or €1,240 per person treated23? How many would say that, in the end, people are a bit responsible for their own weight, once they were shown that cost?
Enough to call the whole shared-risk health model into question.
What we do see, though, is a sharp disconnect between spending on criminalised drugs and on social drugs (tobacco, alcohol), which are perfectly accepted.
Does that mean drug users’ lives are worth more than drinkers’? Or is it precisely proof that many decisions are made irrationally?
The answers to these questions put a price on life directly. But above all they tell us something else: the price of a life depends on a value judgement.