2024-10-10 03:30:00
A few hours before the presentation of the Social Security financing bill (PLFSS), scheduled for Thursday October 10 in the Council of Ministers – almost two weeks late – pressure is mounting on complementary health insurance. Will these private players, who combine mutual societies, insurers and provident institutions, be called upon to contribute? And, as a result, the policyholders, whose contributions could increase accordingly?
The major balances of the budget are becoming clearer for the health sector, and they unsurprisingly augur strong tension: the Social Security deficit is expected to reach 18 billion euros in 2024, when the national objective for insurance expenditure illness, which corresponds to the envelope for hospitals and community medicine registered for 2025, will be set at + 2.8%, the executive announced on October 2. A particularly constrained progression, health stakeholders are already reacting. According to the preparatory budget documents that The World was able to consult, 5 billion savings would be necessary to meet this objective, a figure much higher than the 3.5 billion euros in savings planned for 2023. “transfer measures to complementary organizations” are well documented, without being detailed.
The showdown between the State and the supplementaries over the financing of health spending, which now takes place every autumn, promises to be tense. In the corridors of Bercy and Avenue de Ségur, we are actively working on the hypothesis, revealed Tuesday October 1 by Les Echos, a reduction in the reimbursement rate for medical consultations. This would have an impact on the co-payment, i.e. the amount remaining payable by the patient, then reimbursed by the complementary funds. It currently represents 30% of the price at a general practitioner or specialist, while compulsory health insurance covers the remaining 70%. And possibly, tomorrow, 40%, depending on the executive’s plans currently under arbitration. As a result, more than 1 billion euros could be released.
“Constrained private spending”
The measure falls under the regulatory level, and should therefore not appear in detail within the legislative text, according to a source close to the matter. It would nevertheless constitute one of the main levers chosen by the government to achieve its objectives in terms of reducing Health Insurance expenditure, beyond the usual tools (regulation of drug prices, “efficiency” prescriptions…). In 2023, the same process was used to ratify the doubling of medical deductibles, these sums remaining the responsibility of patients for consultations or the purchase of medicines. A file as sensitive as the one that is coming.
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