2024-10-27 04:30:00
During a consultation with a general practitioner, at the Prevention & Health Center, in Ydes (Cantal), in April 2024. JéRéMIE FULLERINGER/LA MONTAGNE/MAXPPP
“We want to make patients pay for the Social Security deficit, it calls into question the principle of national solidarity”worries Féreuze Aziza, project manager at France Assos Santé, which brings together dozens of user associations. The increase planned by the government, for medical consultations, in the co-payment, i.e. the amount to be paid after reimbursement from Social Security, and covered by complementary health insurance, has put patient associations on alert. Today, this “ticket” represents 30% (and could rise to 40% tomorrow): concretely, out of a price of 26.50 euros for a basic consultation with a general practitioner, 70% is covered by Social Security , or 18.55 euros (of which 2 euros remain the responsibility of the patient as the “flat rate contribution”) and the co-payment represents 7.95 euros.
After the doubling, in 2024, of medical deductibles, these sums which remain their responsibility when patients buy boxes of medicine or consult a health professional, this new savings avenue endorsed by the executive, for 2025, will have “fatally” for effect the increase in complementary contributions, observes the expert. And as a result a “further increased risk of forgoing care”primarily among people who do not benefit from collective contracts (those negotiated by companies), in other words the unemployed, farmers, self-employed workers, precarious workers and retirees. “It is for this last category that we can fear the worst”she insists again, recalling that it is they who, because of their age, and because they take out individual contracts, must pay the highest contributions.
Faced with fears, and even before the subject arrived in the Chamber, with the start of the examination of the Social Security financing bill in the National Assembly, Monday October 28, the government tried to clearing the land: the measure of increase in user fees must spare the most fragile and the sickest, first and foremost patients with long-term illnesses (ALD), we insist at the Ministry of Health. But the speech does not convince.
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The phenomenon is known and documented: these chronically ill people may well be the best covered by Social Security – 100% for care relating to their ALD pathology – but they are also those whose out-of-pocket costs are the greatest. A fact which may seem counterintuitive but which a few figures sum up well: if the sums not reimbursed (neither by Health Insurance nor by complementary insurance) represent an average of 250 euros per person per year, they are more than three times higher for chronically ill people, or 840 euros, according to a June 2024 report from the general inspections of social affairs and finance.
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