The new consultation rates offered to private doctors by the Health Insurance were rejected by five of the six unions in the sector.
By VD with AFP
© Emma BUONCRISTIANI / MAXPPP / PHOTOPQR/LE BIEN PUBLIC/MAXPPP
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LDisagreements were known, failure expected. Five of the six unions of liberal doctors finally rejected the proposals for the new consultation rates, marking the end of the false suspense in the negotiations with the Health Insurance, the Minister of Health deploring a lack of “responsibility”. “There will be no agreement by tomorrow evening, that’s almost certain, even if I still want to believe in common sense,” predicted Minister François Braun on France Inter on Monday morning.
The six unions representing liberal doctors theoretically have until Tuesday evening to say whether or not they accept the new fee schedule proposed for five years by Social Security. But MG France, among the general practitioners, and the Avenir Spé-Le Bloc union, the specialists, have already said “no” on Sunday evening. Without these two organizations weighing more than 30% each in their categories, the draft agreement submitted at the end of last week by Health Insurance was already falling apart. Since then, other unions have followed suit: the SML thus denounced an “anti-liberal” proposal on Monday, while the UFML had announced its opposition “from the start of the negotiations”, indicated its president Jérôme Marty to AFP. .
1.5 billion euros
Monday evening, it was the FMF which announced a massive refusal from its members (97%) of the government project. Social security, however, advanced an annual envelope of 1.5 billion euros, in particular to revalue all medical consultations by 1.50 euros. Or 26.50 euros for the basic rate for general practitioners, maintained at 25 euros since 2017. To obtain a higher price – 30 euros for general practitioners -, practitioners had to subscribe to a “territorial commitment contract” with counterparties your choice: see more patients, participate in on-call duty, practice in a medical desert, consult on Saturdays, etc.
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According to the ministry, more than 40% of doctors already tick these boxes and might thus have earned an average of 20,000 euros more per year without working more. “We asked others to make an effort because we have to meet the health needs of the French”, justifies the entourage of the minister, for whom “unconditional upgrading was not an option”, especially in view of the “colossal sums ” stakes.
“We are going to waste time”
“We are missing an opportunity to improve the care of our fellow citizens”, for his part estimated Mr. Braun, judging that “the unions of doctors are not responsible”. The refusal was however expressed “unanimously” during the internal vote among the general practitioners of MG France, underlined their president Agnès Gianotti. The question of the tariff was “marginal” in the outcome of the ballot, she assured, explaining that her colleagues mainly suffer from a “lack of recognition”.
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A situation that is not regarding to get better, because in the absence of an agreement, the new prices will be set by an “arbitrator”. In this case, a senior official designated by the executive, who will have three months to consult all the protagonists and present a text which, once validated by the minister, will be binding on everyone until the next negotiation. “We will waste time,” lamented Mr. Braun. The budget envelope should in passing be revised downwards: the minister’s entourage does not hide the fact that he “does not want to give the same thing” as if the unions had signed. At the risk of rekindling the anger of doctors, who have already demonstrated twice since the beginning of the year.
Some unions are now agitating the threat of deconvention, which allows doctors to freely set their prices but without any reimbursement of their patients by Social Security. A practice which currently concerns “a little less than 1%” of practitioners according to the ministry. This “would penalize the French even more by creating a two-tier medicine, with only the rich who might treat themselves”, warned Mr. Braun, who is still looking for a cure for the approximately 6 million French people currently without a doctor. In particular for the 600,000 chronically ill people to whom Emmanuel Macron has promised a solution “before the end of the year”. The Minister of Health, who had already announced that these people would be “contacted” before the summer, specified that he would make announcements on this subject “next week”.