2023-10-25 08:00:04
Un budget ” disappointing “, “insincere”, “austerity”, castigated the oppositions; a budget ” ambitious “, « transparent », “controlled”, insisted the government. Two antagonistic readings of the Social Security financing bill (PLFSS) followed one another at the National Assembly, at the opening of discussions in public session, Tuesday October 24.
Hard baptism of fire for the Minister of Health, Aurélien Rousseau, with this “Secu” budget whose examination occurs simultaneously with that of a proposed law on access to care, in the Senate, which makes doctors bristle , and a few days before the reopening of conventional negotiations with the liberal unions.
Facing the deputies, Mr. Rousseau defended the budgetary text, which should make it possible to respond to the “needs of [notre] formidable and fragile health system »he said, and to ensure the “sustainability of the model”. The major balances of this bill are known: with a “Secu” deficit estimated at 8.8 billion euros for 2023, which might reach 11.2 billion euros in 2024, and a “strong dynamism” health expenditure, the national objective for health insurance expenditure (Ondam, i.e. the envelope for hospitals and town medicine) is set at + 3.2% – a level “above expected inflation”for the minister. “We are not at all in an austerity cure”he assured.
Mr. Rousseau did not utter the expression of “medical deductibles” during his first intervention, this controversial issue not yet resolved by the executive, only evoking a “effort to make policyholders responsible” to be debated. The government has been procrastinating for three months over the doubling of these amounts remaining payable by policyholders when they buy a medicine (currently 50 cents per box) or consult a doctor (1 euro). The amounts may seem modest, especially since they are capped at 50 euros per patient per year, but the savings avenue, which is upsetting patient associations and many caregivers, should make it possible to free up 800 million euros. , from ministerial source.
Lack of “mind-blowing” clarity
Speaking following his health counterpart, the budget minister, Thomas Cazenave, came forward more clearly. Referring to the 3.5 billion euros in savings on health spending included in this text, he insisted on the “levers” of “responsibility of policyholders”expected to generate 1.3 billion euros: these savings “might result from the increase in deductibles and fixed contributions, which have not increased since their creation, almost twenty years ago, or from the increase in user fees [soit la somme restant à la charge de l’assuré et relevant des assurances complémentaires] », he said. Way of ensuring that the avenue remains considered, without completely removing the suspense, while, on Tuesday morning, contrary information was circulating in the press. The government will be able to decide later through regulatory channels.
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