Why French Health Workers Are Among the Biggest Losers of Macron’s Pension Reform

Image: Manifestants gather in Paris to protest against Macron's pension reform. Credit: Rai Santana

PARIS, France  —  It is not every day that Vanessa Bletterie catches the Parisian metro on her day off wearing a medical white coat, something she usually reserves for her job at the hospital where she works as a psychologist. 

On the back of her coat, a message written with red and blue marking pens indicates that she is on a different kind of mission today: “Let’s fight to save the world’s best health and social system!”  

She is meeting several of her colleagues but not at the usual psychiatric ward where they look after children and adolescents. They are headed to Place de la République to join hundreds of thousands of demonstrators from several industries, many of whom are gathering for the seventh time this year to protest against the pension reform proposed by President Emmanuel Macron. 

“The government is saying that we need to work more years because our life expectancy has increased, but that does not mean that our bodies are fit to work much longer,” says Bletterie who is also a representative for Sud Santé trade union at the Erasme Public Health Establishment.

The 44-year-old is not alone in her frustration. Across the country, public healthcare workers, especially nurses, have been staging protests and strikes demanding that the government listen to their concerns and protect their rights. France has more than 600,000 nurses and many are criticising Macron for not consulting with them before proposing the reforms, and for failing to take into account the unique challenges and demands of their professions. 

For decades, French health workers were granted special social security benefits, including the right to retire earlier, as they are more likely to work in physically demanding and stressful environments that can take a toll on their health. Under the current pension scheme, they could retire between the ages of 57 and 60, instead of 62, which applies to most other workers. The proposed reform aims to increase the minimum retirement age by at least 2 years for most of the labour force by 2030. 

“On average, women live a healthy life up to the age of 65, and men around 64. With the pension reform, we will either retire when we are already sick or die before retiring,” Bletterie adds while grabbing a snack from her black tote bag featuring the faces and names of key communist figures Lenin, Marx and Engels printed in red.

Image: Vanessa Bletterie (left) and her colleagues at a pension reform protest in Paris. Credit: Rai Santana

The reform also includes changes to the way pensions are calculated, which could result in reduced benefits for healthcare professionals and other public sector workers. The proposed changes would take into account the entire career of a worker, rather than just their 25 best years of earnings, as is currently the case. This means that caregivers who have spent many years in lower-paying jobs, such as nursing assistants or home care aides, will see their pension benefits reduced even further. Many of these health professionals also enter the workforce later in life, having pursued other careers before transitioning into healthcare, which means they will have less time to accumulate pension benefits. 

Furthermore, a significant percentage of these workers are women, who already face systemic disadvantages in terms of salary and access to career advancement opportunities, on top of the added responsibilities of bearing and raising their own children. In some parts of the country, the proportion of female caregivers exceeds 80%. 

French Prime Minister Elisabeth Borne claims that raising the minimum retirement age is “non-negotiable” and an essential step to address the country's ballooning pension deficit. The current retirement system was created in the 1960s when there were four contributors for every retiree. However, today that ratio has decreased to 1.4 contributors per retiree. Additionally, the government maintains that the reform is a necessary adjustment to the 3-year rise in life expectancy across Europe over the past few decades. 

The reform also aims to unify the country's 42 different pension schemes into one, with the aim of making the system more equitable, at least in theory. While the project will impact most sectors of the French workforce, for healthcare workers the changes are the latest blow to a myriad of challenges that have plagued the public health system in the country for decades. 

Hospitals across France are understaffed and most employees are overworked and underpaid. According to a SudOuest report, some of the public health services are lacking up to 40% of paramedical staff (nurses and healthcare assistants). In addition, the French Hospital Federation reported that 99% of establishments face recruitment difficulties, with a shortage of 5 to 6% of nurses and nearly 30% of vacant positions for titular hospital practitioners. The average monthly net pay for agents in the hospital public service is €2,463 (about AU$4,000), one of the lowest among EU nations, according to OECD statistics from 2020. 

Most of these issues originated long before the outbreak of the covid-19 pandemic. Many physicians blame a series of policy decisions by successive governments over the past 3 decades for the decline in the system. The crisis began in 1995, which marked the end of the ‘golden age’ of the healthcare system in the country. Since then, several measures, including cost-cutting, have been implemented under different governments, leading to a strain on the entire system. During Macron’s tenure, no significant changes have been implemented to address the compounded problems concerning health workers. 

Despite nationwide indignation by the workforce and trade unions, the French government is pushing through with pension reform. But some welfare researchers believe that there are viable alternatives to the solution chosen by Macron and his party. One of these alternatives has been studied by Michael Zemmour, an associate professor of economics at Paris 1 University, who claims that raising social security contributions would have been a much fairer way out of the current deficit dilemma. 

"The contributions would be spread among the entire workforce, about 27 million people, while the government's proposed measures to increase the retirement age will only require efforts from those retiring by 2030, about 6 million people," Zemmour explained in a comment to L’Express. 

Among other avenues that have been explored by experts, there is the possibility of increasing the employment rate for senior workers to at least 66% instead of the current 56%, as proposed by French economist Jean-Hervé Lorenzi, founder of Cercle des économistes in an interview with BFMTV. 

Other suggestions include making investments into a supplementary retirement fund compulsory, and, the idea that seems to be especially popular among the protesters, taxing the rich. 

Manifestations throughout the country have shown no sign of slowing down with some trade unions promising to organise weekly protests unless the government decides to abandon its plans to increase the minimum retirement age.