The potion promises to be bitter to the health of the French. While the prime minister is finally preparing to present the trajectory of his public finance recovery plan on Tuesday, July 15, everything suggests that savings will be carried out at the expense of patients.
When refusing to absorb the deficit with an increase in taxes, François Bayrou should logically present a series of measures aimed at reducing, or at least slowing down the increase in public spending.
“The participation, in the next three or four years, is that our entire public spending does not increase 60 billion but 20 billion euros per year,” said Minister of Public Accounts Amélie de Montchalin, guest of the second edition of public expenses meetings, organized by public actors in association with the Court of Auditors on Thursday, July 10. And, to reduce spending speed, health seems to be the privileged objective of the public authorities of the Auditors Court authorities on Thursday, July 10. And to reduce the speed of expenses, health seems to be the privileged objective of the public authorities of the Auditors Court:
Labor unemployed, long -term affections (ALD), drugs … In recent weeks, government, health insurance and employer organizations have prepared spirits for a hardening of serious screws.
Fight against absenteeism at work
With respect to work strikes in particular, several proposals have emerged in the public debate to stop their flight and end the absenteeism at work. In its “positions and products” report, which is supposed to illuminate the government for the security budget by 2026, the National Health Insurance Fund (CNAM) advocates limiting the duration of the disease license.
“The expenses of the daily assignments increased considerably, with an increase of 27.9 % between 2019 and 2023, the CNAM underlines. If this increase is explained to 60% by demographic factors (Increase and aging of the wage population) and economic (increase in the average salary or minimum wage), the remaining participation is linked to an increase in judgments and their frequency. “
The CNM suggests limiting to a maximum of 15 days, the duration of primary prescribed work strikes and one month in case of hospitalization. Any extension of the work strike would require a new medical consultation and would be limited to two months.
To avoid the occurrence of preventable short stops, the CNAM evokes the creation of a bonus/penalty system in companies. A form, in particular, to encourage employers to establish vaccination devices for employees and improve the quality of life at work.
Even more radical, health insurance is considering transferring the financing of the first seven days of working to the employer with maintenance of the current level of coverage for the employee. In return, a day of public deficiency would be established to “deter the stops not related to the disease.”
As a reminder, a day of deficiency called “public order” is distinguished from a classic day of deficiency because it is not compensated by Social Security and cannot be attended by the employer under the monthly law. Therefore, this would be equivalent to saying that employees would not receive any remuneration during these days of illness.
The idea of establishing one or more days of public deficiency in the private sector, since there is already in the public service, pleasure employers organizations. The MEDEF in fact recommends one or three days of deficiency or paid for security, or by the employer, a measure that would bring up to 600 million euros to the société since 2026. The Confederation of small and medium enterprises (CPME) is even more categorical by immediately claiming three days of public cancer.
Less reimbursement
In terms of attention consumption too, the rules could harden. The CNAM report argues a new drop in drug prices, while pharmaceutical laboratories are alarm to significantly lower prices than those practiced by other European countries. Generic medications are attacked, that is, chemical copies of brand medications, whose prices are on average 30% cheaper.
The danger to the French is that the laboratories end no longer produce these tablets, although they are already “generic drugs that are scarcity,” recalls Nathalie Coutinet, professor of Economic Sciences at the University of Paris 13 with BFM businesses.
To avoid such a scenario, the government thinks about planning the margins of pharmacists, lowering the legal roof of commercial discounts that laboratories grant to pharmacies. A strategy far from delighting these daily health professionals, knowing that more than 100 pharmacies have already put the key under the door this year, after 260 pharmacy closures in 2024.
However, to encourage LABO to comply with the desired price reductions, health insurance plans to condition the reimbursement of medications with a medical service under borrowing to effective price reductions, in the order of “20% minimum compared to the net price of the cheapest comparator.”
In other words, if manufacturers refuse to start these efforts, then their products can no longer be reimbursed by security. The Minister of Health and access to care, Yannick Neuder, is not closed to the refund option exclusively and simply to today’s drugs backed by Social Security up to 15%.
Even in order to save money on medication reimbursements, Medef recommends, on the other hand, to develop access to the “Pharmacy of the first resource when providing more optional prescription medications”, as is the case of Paracetamol, for example. In this way, patients would pay these medications from their pockets, health insurance and complementary health insurance only attending the treatments that appear in a recipe written by the doctor.
Reduce sailing in long -term conditions
Another objective led by public authorities to replace security accounts: long -term conditions (ALD). This device, which allows patients with chronic diseases listed in a ministerial decree, benefit from 100% health insurance care as prices used as basic reimbursement, excluding higher rates, is increasingly questioned.
CNAM’s charge and product report suggests that, in fact, the state of ALD with 100% care for patients who have approved a step, in their illness, “that will inevitably become long and expensive, with a strong use of the health system”.
Therefore, another state would be created for patients considered at “chronic risk”, when your doctor has just diagnosed a pathology as a pathology such as obesity, high blood pressure or type 2 diabetes without comorbidity. For these patients, the reimbursement of care would continue to be customary law with shared management between social security and complementary health.
Last year, the General Inspection of Finance (IGF) and the General Inspection of Social Affairs (IGA) recalled, in a report transmitted to the Government in June 2024, that “the ALD system has changed very little since 1986, adapting little to therapeutic developments.” They had markedly quantified between 540 million and 870 million of the possible savings that could have been made by 2025.
Source: BFM TV
