At present, patients pay 23 for each GP visit - more for specialists - and then reclaim 15.10 from the state health service and the balance from their work or private insurance scheme. In future, visits would be free and it would be up to the doctor to claim his or her money.
Another proposed reform would allow chemists to administer routine vaccinations. Doctors' unions say that this will slash the already low income of many GPs.
A new system of regional health bodies would control spending (again broadly reminiscent of the NHS). Unions protest that the regional "commissars" would effectively end the tradition that most French doctors are "liberal", or independent of the state system.
Doctors are also demanding an increase in their "basic" fee to 25 - and pro-rata increases for specialists.
A high proportion of the 90,000 "liberal" or independent doctors will join the strike, due to end on New Year's Day. Emergency cover has been organised, but many surgeries will be closed at a period of high demand.
A separate dispute over working hours in accident and emergency wards appeared to have been resolved, allowing patients deprived of GPs to turn to A&E departments if necessary.
Behind the anger lies the fact that French doctors - especially GPs - earn less than those in almost all other Western European countries. The average earnings of a GP in France are 60,000 a year. This compares with the UK average of 100,000 (127,000) for partners in GP practices, and 70,000 (89,000) for those employed by health trusts.
These figures jar with the high total cost to the taxpayer - 170 billion a year compared with 143 billion for the NHS. The total budget of the French system is around 20 per cent higher. A further share of the costs falls on the private or work insurance schemes called mutuelles.
As a result, France spends 11.9 per cent of GDP on healthcare (of all kinds) compared with 9.6 per cent in the UK. The result is a high-quality system which often comes near the top of world league tables. Critics complain, however, that the service is gold-plated in some areas and dilapidated in others. The budget has been in the red for decades, adding to France's mountain of debt.
Doctors complain that too much is spent on bureaucracy, the unnecessary duplication of some facilities and the relatively high consumption and cost of drugs. As a consequence, doctors' - and other staff - salaries are depressed.
French medical unions also object in principal to the idea of free medical consultations. Jean-Paul Ortiz, head of the largest French medical union, the Confederation des Syndicats Medicaux Francais (CSMF), says that the reform would turn the medical identity card carried by all French citizens - the Carte Vitale - into a "credit card".
"People behave very differently when things are free," he said. "All sense of responsibility will be removed. A doctor's visit will become banal."
- Independent
