2021-12-20 17:35:03
France is, and there is reason to rejoice, one of the developed countries where the out-of-pocket cost of households for healthcare is the lowest. However, the Minister of Health recently initiated a discussion to bring the basic health plan of Social Security closer to supplementary health insurance. Taking advantage of the management costs of the latter, some senior civil servants, economists and elected officials are advocating the elimination of complementary funds to create what they call a “Great Social Security”.
This merger would be far from being a panacea. Its supporters very rarely indicate what level of future increase in the CSG of employees and retirees would be necessary to compensate for the 30 billion euros that complementary health insurance reimburses for their care. They also ignore the predictable consequences of “Grande Secu”. If it is obvious that it will never reimburse everything for everyone, the trend that will then emerge will be to condition the reimbursements of this new general regime on resources, what we will modestly call a “health shield”.
New insurance services
To put it clearly, a remaining liability will be determined by the income of the beneficiary. It is therefore a foregone conclusion that additional funds will be created for wealthy households, with the aim of repaying this new balance. The founding of “Grande Sécu” and the disappearance of the specific existence of current supplementary services would only be the reason for the advent of new insurance services!
For anyone with one foot in real life, this debate is farcical. A Grande Secu will absolutely not change the problems that citizens face when they live in “medical deserts”, when they are forced to travel ever further to find open emergency rooms, or when they have to wait for a while. excessive to call on a specialist. Everything happens as if we wanted to focus the debate on the sole question of the organization of health care reimbursement. However, the response to the needs of the French lies elsewhere. Can we really continue to believe that it is enough to remove the numerus clausus of medical training without confronting the question of freedom of installation to resolve the question of medical deserts? Can we continue to accept that doctors overcharge their fees unjustified by medical added value? The Grande Secu is in no way a social demand. 67% of French people think that responses to health challenges will require them to be “funded by health insurance and complementary health insurance”with only 12% believing that they will have to “be financed by health insurance alone”, according to a recent BVA study.
→ REREAD. For Social Security, a historic deficit but less than feared
Complementaries must put in place solidarity mechanisms
However, complementary health insurance cannot of course be exempt from all consideration. They must transcend their discourse tending towards corporatism to tackle subjects which are their sole responsibility. One of the main ones is the problem of contract pricing. For employees, contracts are collective, and employee contributions are made as a percentage of remuneration. For self-employed people, particularly retirees, individual contracts have their prices set at a fixed amount based on age, in short, completely independent of the pension. It is urgent that complementary organizations work to establish collective solidarity mechanisms for greater social justice in their pricing of individual contracts for retirees, widowers and the unemployed.
As the WHO states, health is “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”. This issue of well-being, both mental and social, has been highlighted by the Covid crisis. This is a real problem that must challenge society. And which should mobilize us, much more than debates which look at our health system and its issues through the small end of the lens!
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