They have become “difficult to bear for a part of the population.” Although the practice of exceeding fees tends to be widespread among some specialist doctors, a parliamentary mission, entrusted by former Prime Minister François Bayrou, recommends limiting them.
If the excess fees “have made it possible to reduce Health Insurance expenses by simultaneously increasing the remuneration of doctors”, “their progressive generalization among specialist doctors has harmful effects on access to healthcare”, emphasize Yannick Monnet (PCF) and Jean-François Rousset (EPR), commissioned by Matignon’s former tenant to draw up an inventory and make recommendations.
4.5 billion euros in 2024
Various attempts at regulation in the last 30 years have not been enough to counteract its growth: the total amount of cost overruns increases every year (4.5 billion euros in 2024) and more and more doctors are settling in sector 2 (three quarters of new facilities in 2024). This raises fears of a “definitive disappearance of sector 1,” according to elected officials. Sector 1 is, however, mandatory for general practitioners who wish to conclude an agreement with health insurance, which prevents them, with rare exceptions, from charging excessive fees to their patients.
Thus, the only alternative for general practitioners who want to charge prices higher than the 30 euros currently charged per consultation is to choose not to take out Health Insurance. But then their patients would hardly receive a refund from Social Security.
As for specialists, however, they have the option to choose between sector 1, sector 2 and sector 2 with a controlled price practice option (Optam) to agree with Health Insurance. Sector 2 with Optam authorizes them to exceed the rates in exchange for a commitment, on the part of the professionals, to limit them. Thus, some patients will pay more than others for their consultation with the same specialist who has chosen this option.
Fixed price, or even prohibit excesses in certain acts?
While they claim to have examined several scenarios, including a complete ban on excessive fees, Yannick Monnet and Jean-François Rousset ultimately recommend “a limit,” in their hundred-page report. They ask to “reduce, or even eliminate” these excesses “in acts important to the health of the French”: a fixed rate, or even a prohibition of excesses in the case of repeated acts and consultations within the framework of an episode of care or for certain pathologies (such as cancer), and a prohibition of certain preventive acts and examinations.
The authors of the mission also advocate that sanctions be imposed in case of excesses. Yannick Monnet and Jean-François Rousset also defend greater compensation for the exercise in sector 2 and the possibility of cost overruns, through the review of the nomenclature of technical acts (CCAM). Another recommendation: make more French people benefit from the Solidarity Health Supplement (C2S), which protects against excess fees, by raising the resource thresholds to access it.
Source: BFM TV
