2024-02-09 23:07:47
Social Security wants to rethink the way doctors are paid. To improve the medical care of the French, Health Insurance wishes to supplement the remuneration of general practitioners for consultations by paying a higher or lower flat rate depending on the profile of their patients.
“We really have the feeling that we are proposing quite innovative things,” insisted the head of Health Insurance, Thomas Fatôme, Thursday evening, after a meeting with the unions of private doctors. In full negotiation with the latter to redefine their conditions of practice and remuneration, the organization has already shown itself ready to increase the price of consultation of general practitioners from 26.50 to 30 euros.
Encouraged to do as much as possible
At the same time, he unveiled a review of the fixed remuneration of doctors. A way of putting into music the idea dear to Emmanuel Macron, of rewarding doctors for the overall care of each patient rather than encouraging them to have one consultation after another. “Today you are not encouraged to do prevention […] rather, you are encouraged to do as much as possible,” the president lamented to the press in mid-January, pleading for “more intelligent remuneration.”
While today there are several packages, with multiple conditions to be met to obtain additional remuneration, Health Insurance wants to focus on a single package. Enough, she says, to simplify the lives of doctors. “Professionals rightly find that their remuneration is a little complex and that it needs to be clarified,” defended the number two of the organization, Marguerite Cazeneuve.
Tailor-made remuneration
In practice, the new package would be completely tailor-made and adjusted according to the age and state of health of the different patients. A general practitioner would receive at least 55 euros each year per chronic patient followed and 80 euros if this patient is elderly. He could earn even more if his elderly diabetic patient has been vaccinated against the flu or has received screening.
In this way, doctors would be better paid as they support a large number of vulnerable people (young children, chronically ill people) and focus on prevention. With this system, elderly doctors, newly established, or having their practices in a medical desert, could earn even more than their colleagues.
« Monopoly des patients »
Health Insurance promises that this involves “considerably strengthening” the package supposed to reward patient monitoring (the attending physician patient package). This represents a little less than 10% of consultations with general practitioners. However, she did not specify Thursday to what extent her new package would increase doctors’ income.
These proposals are viewed with interest by the leading general practitioner union, MG France. This considers it essential to reward doctors who follow their patients very closely compared to those who carry out consultations with people they never see again. Especially as teleconsultation platforms or centers for urgent care are developing. “We will have to do (financial) simulations,” however, warned Agnès Giannotti, head of MG France, a key union for the success of the current negotiations.
Weighing less heavily in the discussions, the Federation of Doctors of France is however much more critical. “A new, very beautiful gas plant is being prepared,” the union said on its website. It’s the Monopoly of patients.”
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