a tense equation for the future government

2024-09-11 03:30:06
Michel Barnier, during his first trip as Prime Minister, to Necker Hospital, in Paris, on September 7, 2024. LUDOVIC MARIN / AFP

How to stop health spending that increases year after year? The sea serpent of a stronger control of sick leave resurfaces, while budgetary problems and the challenge of redressing public finances occupy the forefront of the political scene.

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In front of the press, Monday September 9, the head of the National Health Insurance Fund (CNAM), Thomas Fatôme, urged the executive to “to take hold of the issue”emphasizing a “growth in spending” work stoppages, which turned out to be “extremely fast” in the first half of 2024. One possible savings path among others, which will have to be enacted – or not – in the Social Security financing bill (PLFSS) planned for the fall, but whose preparation is at a standstill, pending the formation of a government. The future deficits of the health branch of Social Security will be “likely higher than expected” – exceeding 11.4 billion euros.

In hospitals as in the ranks of community medicine, the fate reserved for the health sector is at the heart of concerns. During his first visit as Prime Minister, Saturday, September 7, to the Necker hospital in Paris, Michel Barnier told caregivers that there are “savings to be made”while promising “progress in spending efficiency”, pour “preserve public service”.

Request for “cost-effective funding”

While the PLFSS is due to arrive in the Chamber on 1 October – unless there is a change of schedule – several elements of the budgetary equation are already known. As early as July, the alert committee on the evolution of health insurance expenditure highlighted this: there is already a “high risk of overrun” concerning city care (at private doctors) of approximately 1 billion euros over the year 2024, when the objective set for this section represented 108.4 billion euros.

This shift is explained by the “dynamics” of care, but also by an initial revaluation of the consultation fee (from 25 to 26.50 euros, in November 2023). The trend is set to continue in 2025, with the translation into the budget columns of the “medical convention”, this new contract signed in June by Health Insurance with private doctors. After months of heated negotiations, this has enacted a series of revaluations – including the basic consultation, which will be increased to 30 euros from December.

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