Access to health care and social inequalities in general medicine

As general practitioners, we are more and more confronted to social inequalities in health and uneven access to primary care. Our health care system's mission is to protect each people, including the most vulnerable ones. However, this equal access to all is worsening and we are the principal witnesses of it. The recent publications from French official organisms confirm this statement and underline the impacts on social cohesion and public health. Difficulties for subscribing to complementary insurances, fees and extra fixed amounts or problems with the third party payer system are major obstacles to primary care access for the poorest ones. The public institutions propose contradictory, unclear and thus inefficient solutions. If we want to continue to practice our job in consistence with its deontology, if we want to continue to defend a health care system considered in 2000 by the WHO as "the most efficient system in term of dispensation and organization of health care", we have to react and make sure that the public politics preserve an universal access to health care. More widely, our academic experiences in primary care should integrate data from studies about inequalities in health and prepare the future generation to this great challenge of the 21st century.