2023-06-23 09:00:06
The budget debates do not enter the hard, officially, until the start of the school year, but the tone is already set: health expenditure appears in the viewfinder of the government. Three avenues for savings, put forward in quick succession by the Ministry of Health and Bercy, in recent weeks, are already reacting, from the benches of the Hemicycle to medical offices.
It was first a question of a reinforced control of the issuance of sick leave, the cost of which – excluding Covid-19 – represented more than 14 billion euros in 2022. That is an increase of 30% over ten years, we figure at the Ministry of Health.
Then there was the announcement, on June 15, of a change in the reimbursement of dental care: the part covered by Social Security must go from 70% to 60%, when that of health insurance goes, to compensate, increase by 30% to 40%. Either a transfer estimated at 500 million euros in a full year. On this point, the calendar is known: the change will be effective on October 1st.
Change of “logic”
The third measurement, yet only at the stage of the hypothesis, could augur a change of gear. Are we going to make the French pay more for access to medicines? Speaking at the Assises des finances publiques on June 19, the Minister of the Economy, Bruno Le Maire, in fact targeted the “drifts in drug spending” and judged that their “virtually free can relieve the patient of responsibility”. Remarks which have raised the fear of an increase in medical deductibles, sums not reimbursed by the “Safety” on boxes of medicines (50 euro cents), certain paramedical acts (50 cents), and medical transport (2 euros), for a maximum envelope of 50 euros per year and per patient. An amount unchanged since their introduction in 2008. Doubling the deductible to bring it to 1 euro could bring in 500 to 600 million euros, according to a calculation by Bercy reported by The echoes.
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“Nothing is done”we nevertheless remind the Ministry of Health, where we are assured of working on “all possible avenues of financing, with a more difficult budget equation than before”. “I will be vigilant on the evolution of the mechanisms which govern the increase in the remainder to be paid for by the insured”says Minister François Braun.
“Accounting Choices”pinned the opposition to the Assembly on June 20. “A line of budgetary responsibility”we on the contrary defended in the presidential camp.
In the world of health, some are already worried about a “plane stroke”. “The Masks Are Falling”reacted Agnès Giannotti, the president of the union of general practitioners MG France, in a “Letter to the People”. She denounces the “signal of a gradual divestment of Health Insurance and the decline of the State in the field of health”.
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The change initiated does not surprise the health economist Nicolas Da Silva: after the explosion of expenditure linked to the health crisis, the government wants to initiate a ” takeover “ of these and return to the “previous trajectory of reduction in the share of social security in health expenditure”. “Making more drugs pay, it looks like the strategy of the 1980s-1990she adds. A period of increased renunciation of care among the French. »
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