2023-12-05 04:15:02
Does State medical aid (AME) have an “attractive effect”? Should we modify the care covered by this health coverage which, by mid-2023, benefited nearly 440,000 undocumented foreigners? Does a reform involve risks for public health or hospital finances?
These are the questions that the evaluation mission entrusted by the government to the former socialist minister of health, Claude Evin, and the former prefect and right-wing man, Patrick Stefanini, had to answer. Work published Monday, December 4, while the Senate voted, in November, an amendment to remove the AME during the examination of the “immigration” bill. The right and the center thus aimed to fight against the expenses linked to this system, which amount to around 1 billion euros.
A few days before the text arrives in public session, on December 11, at the National Assembly, the Evin-Stefanini report offers a way out to the government, divided on the need to tackle the AME. On the one hand, to pass his law, the Minister of the Interior, Gérald Darmanin, wants to find common ground with the right in whose eyes the AME is the symbol of laissez-faire migration; on the other hand, the Prime Minister, Elisabeth Borne, the government spokesperson, Olivier Véran, and the Minister of Health, Aurélien Rousseau, demonstrated their attachment to the AME, echoing a overwhelming majority opinion within the medical world.
At the cost of some paradoxes, the proposals formulated by the rapporteurs oscillate between these two lines. They “may be subject to regulatory or legislative change”, declared, Monday, Mr. Darmanin and Mr. Rousseau in a joint press release, believing on the other hand that they could not be integrated into the “immigration” law, at the risk of being rejected by the Constitutional Council because they are considered as “legislative riders”, that is to say which have no link with the text. The National Assembly’s law committee has already deleted the senatorial amendment burying the AME.
“Confirmed health usefulness”
Called upon to shed light on the debates, Mr. Stefanini and Mr. Evin affirm that “the health utility [de l’AME] is confirmed ». They believe that the Senate’s project to replace the AME with emergency medical aid includes a “significant risk of forgoing care”, Who “would have the triple impact of a deterioration in the state of health of the people concerned, possible consequences on public health and increased pressure on health establishments”. Without AME, foreigners would no longer be able to use community medicine, would place greater demands on hospitals, in more degraded conditions, and therefore be more costly for the healthcare system.
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