2023-07-11 03:15:47
Biology laboratories yesterday, radiology practices today, and perhaps health centers tomorrow: the growing influence of investment funds on the health system worries the world of health.
Social Security has chosen to devote several pages of its 2023 “Expenses and products” report to the “financialization of the healthcare offer”, a voluminous annual report which scrutinizes the French healthcare system.
The takeover of laboratories, surgeries and other places of care by investment funds is a “fundamental trend that needs to be better understood and regulated”, she writes, calling in particular to strengthen the “transparency” of these operations, against business secrecy.
“We are facing a phenomenon of financialization which is spreading, in new fields such as that of radiology, and raises questions”, summed up the director general of the Cnam, Thomas Fatôme, in an interview with Les Echos on Monday.
The public authorities have in particular in mind the showdown initiated in the fall with biology laboratories, at least 60% of whose activity is now controlled by six major players, after an unprecedented wave of concentration during the 2010s. -2020.
“When Health Insurance wanted to lower the prices of biologists, the fact that the laboratories are now owned by investment funds with clear logic of speculation has made the discussions very complicated, with threats of site closures for example and calling into question the service provided to the insured”, explained Mr. Fatôme.
Jean-Philippe Masson, the president of the national federation of radiologists, welcomes this increased mistrust vis-à-vis investment funds.
“10 to 15% of radiology practices are now in the hands of financial players. This must stop,” he told AFP.
Bypassed guardrails
Once they have taken control of radiology practices, these financial funds impose management requirements that conflict with the proper functioning of the healthcare system, according to him.
“Some firms are being asked to multiply certain examinations which are better paid, to the detriment of others which are less so”, continues Jean-Philippe Masson. “Financial funds impose turnover growth objectives of 5% on firms, while the average growth in the sector is currently only 1 to 2% at the most”.
The law has provided safeguards so that doctors, biologists, radiologists or other specialists retain control of the structures they run.
But financial investors have been able to find tricks to circumvent these safeguards, explain many experts.
“It is possible” for the funds “to grant 75% of the voting rights to practitioners but to retain almost all the financial rights and to exercise de facto control of the groups”, underlines the Social Security in its report “ expenses and products”.
“I am impatiently awaiting” the decrees implementing a government ordinance of February 2022 on regulated liberal professions, which should compel financial groups to be transparent about their relations with co-shareholder doctors, declares for his part Mr. Masson.
Patrick Gasser, president of the Avenir Spé doctors’ union, is delighted with the recent awareness of the influence of investment funds, particularly after the Orpea scandal, the private group of retirement homes and nursing homes.
“But it’s not just rotten investments,” he notes.
The world of health “needs external, but sustainable investment”, he continues. If only to help young doctors buy back the structures put in place by their elders.
A decision of the Council of State made public on Monday can in any case give hope to the proponents of non-financialized health.
The high administrative court considered that the order of veterinarians – a regulated profession, like doctors – had been right to strike off practitioners whose centers were in fact controlled by financial partners such as investment funds, or by professionals who do not carry out any activity there.
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