2023-09-24 05:31:00
In the event of chronic illness and long-term illness, a doctor can prescribe physical activity sessions, but they are not reimbursed by Social Security. However, things might change for certain pathologies.
Cancers, mild depression, diabetes: scientific studies have been proving for years the benefits of physical activity alongside treatments.
Hence these so-called “adapted physical activity” (APA) sessions, permitted since a 2016 law, and partly covered by certain mutual insurance companies.
The sports law promulgated in March 2022 even extended the list of pathologies that can justify an APA to certain chronic illnesses as well as loss of autonomy for the elderly, for example.
Twenty million people
“This represents more than 20 million people in France,” explains Martine Duclos, endocrinologist and physiologist, president of the National Observatory of Physical Activity and Sedentary Lifestyle (Onaps).
She notes in passing that the benefits of physical activity, whether for prevention or treatment – not running a 10 km but just walking, taking the stairs or gardening – are sometimes unknown to doctors themselves. “For two years, it has been integrated into the training of medical students,” she explains.
Concretely, a cycle of adapted physical activity consists of two to three weekly sessions for a minimum of three months, in particular at Maisons sport-santé, establishments created in 2019. It varies depending on the pathologies. Near Dunkirk (North), it is on board a bus, at the initiative of a cancer specialist, that the DK Pulse association takes sessions to patients’ homes.
The financial support for the assessment prior to the sessions for a person suffering from cancer was decided in 2020 to the tune of 180 euros. But the sessions themselves are still not reimbursed. Some regional health agencies (ARS) are getting their hands dirty.
Some experiments, such as that carried out in Nice by the Azur Santé association for patients suffering from cardiovascular pathologies, are supported.
“Cancer and diabetes”
This summer, Health Insurance proposed in its 2024 report “to initiate this support by targeting people with cancer or diabetes”. The discussion is underway with the public authorities.
During an Olympic council held in July, Emmanuel Macron expressed the wish that “adapted physical activity benefits from common law coverage by compulsory health insurance or complementary health organizations for certain Care course”.
The question is whether this wish will be made a reality in the next Social Security financing bill (PLFSS)? “Non-reimbursement is one of the obstacles” to the development of the APA, explains Martine Duclos who participated in a report on sport and health, submitted this summer, which recommends treatment for “all illnesses chronicles.”
Especially since these diseases can affect populations “who do not have mutual insurance” and “difficult access to care”. A session can cost “40 euros”, a decreasing rate for groups, she adds. For former MP Régis Juanico (Génération.s), “we need an “act II” of adapted physical activity with reimbursement”.
Author of the book “Let’s move, manifesto for more active lifestyles”, he explains that “we should start by reimbursing the first consultation”, assessment and questionnaire, consultation which is not reimbursed.
According to several studies, including one carried out in 2021 by the National Cancer Institute, doctors rarely prescribe appropriate physical activity, due to lack of training and also “due to lack of visibility and funding”.
“Apart from a few cities, like Strasbourg or Libourne, strongly mobilized because there is a political will, the doctor is alone,” continues the former MP. He is also vigilant so that sports-health centers can have “sustainable financing”.
With a view to the future parliamentary debate around the PLFSS, he recognizes that “the communication difficulty for the government today is, on the one hand, an increase in healthcare spending, and on the other, saying we are going to make other expenses,” he said.
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