2024-11-02 06:00:00
If there is a widely repeated attack in the ranks of the opposition during the consideration of the draft bill on the financing of social security (PLFSS) for 2025, which continues in the National Assembly until the solemn vote scheduled for November 5, it is that of the absence of structural measures in the face of a healthcare system in crisis. «There is a word that never appears: “medical desert”. It is the unthought, the invisible of your PLFSS”declared the socialist deputy of Essonne Jérôme Guedj, opening the proceedings on Monday 28 October.
For several weeks, in the debates in the medical community and beyond, various proposals have re-emerged which raise the delicate question of constraints on the establishment of doctors to fight against medical deserts. This red flag of the profession, defended by a certain number of elected representatives in the Chamber, has always been rejected during the two mandates of President Emmanuel Macron.
“This topic deserves a text of its own”
The proposal echoes that put forward for some time by the socialist deputy Guillaume Garot (Mayenne), with a transpartisan group, rejected during the examination of the Valletoux law on access to care, in winter 2023. This group was reconstituted after the dissolution of the National Assembly in June and now brings together almost a hundred parliamentarians from all groups – with the exception of the National Rally. He just put the finishing touches on a proposal that includes this same measure. “This topic deserves a separate text to be discussed as quickly as possible, rather than an amendment to the PLFSS”defends the left-wing deputy, who is targeting the early 2025 window, as part of the National Assembly week, dedicated to deputies’ proposals.
On the government side, the tone of the Minister of Health, Geneviève Darrieussecq, appeared surprisingly open on this explosive issue. In France Culture, on Saturday 26 October, he threw the key into the pond, without warning: referring to dentists, who a year ago adopted a regulatory measure (an arrival for a departure) in areas considered over-equipped (the application is scheduled for 2025), the former Landes MP has passed the buck onto the doctors. “Maybe the Order [des médecins] could introduce a point of regulation in overcrowded areas, in any case so that there are no inadequate installations. »
Interview with Professor Anne Morrissey, Healthcare Policy Expert
Editor (Time.news): Thank you for joining us today, Professor Morrissey. The current discussions surrounding the draft bill on the financing of social security have highlighted significant concerns about our healthcare system. How do you assess the situation with “medical deserts” as highlighted by Deputy Jérôme Guedj?
Professor Morrissey: Thank you for having me. The term “medical desert” is crucial to understanding the systemic issues plaguing our healthcare system. These areas suffer from a lack of doctors and essential services, which is alarming. Jérôme Guedj’s statements reflect a growing frustration regarding the absence of substantive measures in the proposed bill. As the population ages and healthcare demands increase, we can’t ignore the regions that lack access.
Editor: You mentioned systemic issues. Can you elaborate on the underlying causes of these medical deserts?
Professor Morrissey: Certainly. There are several factors at play. First, we have a maldistribution of healthcare professionals. Many doctors prefer to practice in urban areas where facilities and lifestyle can be more appealing. There’s also the issue of educational and financial barriers that prevent new doctors from establishing themselves in underserved regions. Additionally, we must consider policy decisions that have historically focused more on urban centers and less on rural needs.
Editor: The proposal to impose constraints on the establishment of new medical practices in certain areas has been contentious. Do you believe this is a viable solution?
Professor Morrissey: It can be a double-edged sword. While some form of incentive or constraint may be necessary to guide healthcare professionals towards areas of need, we must ensure that it doesn’t deter new graduates altogether. Incentive programs, like student loan forgiveness or enhanced salaries for those who practice in underserved areas, might be more effective. It’s about finding the right balance between regulation and support.
Editor: In the context of the current political climate and discussions in the National Assembly, do you think there is political will to take on the issue of medical deserts seriously?
Professor Morrissey: There seems to be a growing recognition of the problem at some levels of government, especially with increasing pressure from constituents struggling with access to care. However, previous administrations, including President Macron’s, have been reticent to implement structural changes due to the complexity and political ramifications involved. It will ultimately come down to how insistent the opposition and public opinion are in pushing for real solutions.
Editor: As articles like this reflect, the healthcare system is at a pivotal juncture. What do you foresee as the next steps needed to address these systemic issues effectively?
Professor Morrissey: The first step is to openly acknowledge the problem and engage in dialogue, much like we are doing now. We need collaborative efforts involving healthcare professionals, policymakers, and communities to draft a comprehensive strategy. They could consider pilot programs that trial new models of care in these deserts, improved funding for telemedicine, and perhaps even revising how medical schools allocate residency positions to favor these underserved areas.
Editor: Thank you, Professor Morrissey. Your insights shed light on a complex issue that deserves urgent attention, as healthcare should be a right for all, regardless of geographical location.
Professor Morrissey: Thank you for addressing this important topic. It’s crucial that we keep the dialogue open and push for actionable strategies to ensure equitable healthcare for every citizen.