Vitale future is wide open

The French government announced the national healthcare card, called Carte Vitale, is bound to be dematerialized or merged into the ID card.

The Carte Vitale was launched in 1998, as a support for healthcare rights. At that time, it even did not bear a photo on the card and the chip only contained administrative data. Then came the second version: Vitale 2, in 2007, bearing a photo of the cardholder, and which was supposed to include health-related data, something that never happened.

In fact, the Carte Vitale 1 has been very useful for a purpose that was not part of the original project: testing the actual life expectancy of the chip. The project was launched in 1998, with a mass distribution of cards in 1999. These cards where using a SGS-Thomson (now ST Microelectronics) ST16SF44 chip with Bull CP8 (now part of Thales) Scot 400 mask. The chip was an 8-bit microcontroller with 4 k bytes of EEPROM memory. When the project was launched, the card was expected to have a life expectancy of 3 years and the chip was guaranteed for 5 years. As of now, millions of cards issued in 1998-1999 are still in operation, almost a quarter of a century after having been manufactured!

Even with a photo on most cards, fraud to social services is evaluated between EUR 6 and 8 billion yearly. This amount is a sufficient trigger for the government to try and find solutions.

The first solution that was considered is to turn the Carte Vitale into a Digital ID, by dematerializing it on the patient's smartphone. The ApCV (Application Carte Vitale) contains an identifier (INS - Identité Nationale de Santé – National Health ID), access to optional insurance credentials, and allows medical acts billing, and online access to health-related data. It is to become an identity supplier function certified at eIDAS substantial level, for instance to be used by France Connect, the inter-administration authentication service for citizens' access. A pilot has been conducted in 10 departments, but no rollout date has been announced yet.

Already dematerialized smartphone versions of healthcare cards are in use in Denmark, Australia, and more, along with some US states and Canadian provinces.

Now, the French government is coming up with a new approach: merging the healthcare card with the national eID card. Again, nothing new here, this is already the case in many countries including Estonia, Belgium and Portugal, among others, as well as many countries in West Africa, as interoperability is guaranteed by the fact ECOWAS (Economic Community of West African States) has decided to issue ICAO-compliant national ID cards.

Adding healthcare rights on a national ID card can seem a good idea, however, the CNIL (Commission nationale de l'informatique et des libertés - National Commission on Informatics and Liberty) has issued a statement in which they insist on data protection, especially on keeping the national ID number in a secure area of the chip and not printed on the card, along with other limitations.

No decision is made yet. My Carte Vitale issued in 1999 will probably see its lifetime extended by a few more years ...