2023-08-27 15:30:11
Again state medical aid is in jeopardy. On June 7, a motion for a resolution from the Les Républicains party was presented to the National Assembly to fight against the skidding in the cost of health coverage for foreigners in an irregular situation 1. According to the authors of this resolution, the amount of the various health aids provided to undocumented foreigners, of which state medical aid (AME) constitutes the keystone, is estimated at 1.7 billion euros. An expenditure which should explode in the near future, since the number of beneficiaries of the AME increased by +20.5% in 2022. As a reminder, the AME “allows its beneficiaries to have, without advance payment, ‘100% coverage of medical and hospital care reimbursable by health insurance within the limits of Social Security tariffs’, recalls the authors of this resolution, who are protesting against the fact that in “France, and unlike other European countries, the basket of covered care is not limited to urgent care and provides access to non-essential care such as the reattachment of the ears or the installation of a gastric band”. The LR deputies also denounce the mismanagement at work with regard to the application of the ten other health aids devolved to foreigners in an irregular situation.
Urgent care only
The proposal mainly proposed reforming the AME to refocus it solely on urgent care. But also to tighten the conditions of access “to the mechanism for maintaining rights”to “restrict the conditions of access to the procedure for admission to stay for care”, and to “modify the health protection of asylum seekers from safe countries of origin”. This motion for a resolution was rejected by 120 votes to 77 on June 7, but it caused a stir, especially among doctors. Thus, the Society of Infectious Pathology (SPILF), the French Language Resuscitation Society (SRLF), the French Society of Public Health (SFSP), the French Society of Pediatrics (SFP) and the French Society of Emergency Medicine ( SFMU) co-signed a forum against the abolition of the AME 2. It had initially been drafted against an amendment by removal of the AME dating from March as part of the immigration law review 3, but learned societies have republished it to oppose this new motion for a resolution.
Nonsense
The learned societies are against the reform or the abolition of the AME, for several reasons: these measures, of abolition or restriction of the AME, are nonsense “from an economic point of view, the late hospitalization of pathologies being particularly costly, and will limit access to care for an already vulnerable population. Moreover, all the demographic studies show that migration for health reasons is a minority among the reasons for leaving the countries of origin, that our social protection system is globally unknown to migrants, and that its restriction will have no effect on migratory flows”.
PASS and SAU overload
The restriction of the AME could lead to “an unbearable overload of the Health Care Access Points (PASS) and the already saturated Reception and Emergency Services (SAU), an over-solicitation of specialized resources (care specialists, hospitalizations and recourse to critical care) and an increase in the duration of hospitalizations due to the impossibility of transferring patients to follow-up and rehabilitation care”. Learned societies also relativize the so-called exorbitant cost of the AME: “The cost of care covered by state medical aid and the urgent and vital care system, although significant, represents only 0.4% of expenditure health insurance in France. They conclude their forum by recalling that “according to the WHO, the possession of the best state of health that he is capable of achieving constitutes one of the fundamental rights of all human beings, whatever their condition”. In short, for learned societies, don’t touch the AME!
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