Par
Briac Trebert
Published on Sep 10, 2024 at 1:03 p.m.
In order to “preserve a health insurance system”, the government intends to track down those who take too much sick leave.
“It is not a question of casting anathema on doctors, nor on insured persons, nor on companies,” justified this Tuesday, September 10, 2024 on Franceinfo Thomas Fatôme, the general director of the national health insurance fund (CNAM). But it is nevertheless indeed a manhunt.
Concerned about the growth in spending linked to work stoppages in 2024, health insurance announced, this Monday, September 9, 2024, to deploy a “2024-2025” action planand calls on politicians and social partners to renovate the system to make it “more sustainable” and “more equitable”.
Health Insurance will contact certain insured persons
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Table of Contents
The context is that expenditure related to work stoppages started to rise again in the first half of the year and should “increase by more than a billion euros in 2024”, to possibly “exceed 17 billion” at the end of the year, Thomas Fatôme stated in the preamble.
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Health insurance thus announces that it wants to “track down” fraud, but also to “support” patients and prescribers, to improve practices.
Concretely, the Cnam will massively address social security beneficiaries: it will contact “all insured persons on sick leave for more than 18 months”, i.e. 30,000 to 40,000 people, to “check whether the sick leave is still justified”, or whether it is possible to adapt it with, for example, “therapeutic part-time work”, or “an organized return to work”.
A letter to “remind the rules”
Insured persons who have had “at least two absences of less than two weeks” over a period of six months (except pregnant women, chronically ill people, etc.) will receive a letter to “remind them of the rules” and offer them “support”.
And the Cnam will also contact “7,000 general practitioners who have fairly high prescription levels”, with a view “not to checks”, but to a “fraternal exchange” with a medical advisor, to “understand” and “see if they can contribute to better control of expenditure”, indicates Thomas Fatôme.
Health Insurance is also starting to send its network of primary health insurance funds new “highly secure” sick leave forms, made available to doctors who request them. Their use will be mandatory from June 2025.
Visits to a thousand companies
The causes of the increase in health expenditure are “multifactorial”, admits the head of the Cnam, but he nevertheless wishes to tackle fraud. “We have summoned 270,000 insured persons in 2023 on the basis of targeting. In approximately 30% of cases, the work stoppage is not justified”, he indicated.
The Cnam will finally organize visits to a thousand companies with a profile of “very high absenteeism” to check whether they are not creating “the conditions” for these work stoppages or accidents.
And in addition to these actions, Thomas Fatôme therefore called for “bringing all the stakeholders around the table” (government, Parliament, social partners, etc.) to conduct “a more general reflection” on the system, and “make it fairer, more equitable, more readable, more sustainable.”
For Thomas Fatôme, “we also have issues of fairness.” He questions in particular the fact that employees in large companies are often covered for the first three waiting days and those in small businesses are much less so. And thus proposes to the social partners to “sit around the table” to discuss “all the subjects”.
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Here is a question that aligns with the title “Reducing Work Stoppage Expenditure in France: A Comprehensive Approach”:
Reducing Work Stoppage Expenditure in France: A Comprehensive Approach
France’s national health insurance fund (CNAM) has announced a series of measures to tackle the growing expenditure on work stoppages, which is expected to exceed 17 billion euros by the end of 2024 [[1]]. The “2024-2025” action plan aims to track down fraud, support patients and prescribers, and improve practices to make the system more sustainable and equitable [[2]].
Contacting Insured Persons and General Practitioners
As part of the plan, CNAM will contact approximately 30,000 to 40,000 insured persons who have been on sick leave for more than 18 months to check whether their sick leave is still justified or can be adapted with therapeutic part-time work or an organized return to work [[1]]. Additionally, insured persons who have had at least two absences of less than two weeks over a period of six months will receive a letter to remind them of the rules and offer support [[1]]. CNAM will also contact 7,000 general practitioners with high prescription levels to engage in a “fraternal exchange” and understand how they can contribute to better control of expenditure [[1]].
New Sick Leave Forms and Company Visits
CNAM is introducing new “highly secure” sick leave forms, which will be mandatory from June 2025, and will organize visits to a thousand companies with high absenteeism profiles to check whether they are creating conditions that lead to work stoppages or accidents [[1]]. These measures are part of a broader effort to tackle fraud, which has been identified as a significant factor in the increase in health expenditure.
The Impact of Mass Layoffs on Mental Health
In a related context, research has shown that mass layoffs can have a significant impact on the mental health of workers remaining in plants after layoffs [[3]]. This highlights the need for companies to prioritize employee well-being and provide support during periods of restructuring.
Redundancy in France
In France, companies with more than 50 employees are subject to specific regulations when it comes to reductions in force (RIF) [[2]]. Employers must follow a clearly defined procedure, which includes informing and consulting with employees, providing support, and ensuring fair redundancy pay and entitlements. Companies must also take steps to minimize the impact of RIF on employees and provide support during the transition period [[2]].
Termination of Employment in France
In general, termination of employment in France is governed by strict regulations, and employers must follow a fair and transparent process when ending an employment contract [[2]]. This includes providing clear reasons for termination, following the correct notice period, and ensuring fair redundancy pay and entitlements.
Conclusion
The CNAM’s “2024-2025” action plan is a welcome step towards addressing the growing expenditure on work stoppages in France. By tackling fraud, supporting patients and prescribers, and improving practices, the system can become more sustainable and equitable. Additionally, companies must prioritize employee well-being during periods of restructuring and follow fair and transparent procedures when terminating employment contracts.
French government spending pie chart
Reducing Work Stoppage Expenditure in France: A Comprehensive Approach
In recent years, France has been facing a significant increase in expenditure related to work stoppages, which is expected to exceed 17 billion euros by the end of 2024 [[1]]. To address this issue, the French government has announced a plan to track down those who take too much sick leave and to renovate the health insurance system to make it more sustainable and equitable.
The French Healthcare System
France has a public healthcare system known as Sécurité Sociale, which provides basic coverage to those who qualify and is funded by taxes [[2]]. The system is designed to provide universal health care, largely financed by government national health insurance [[3]].
Government’s Plan to Reduce Work Stoppage Expenditure
The government’s plan to reduce work stoppage expenditure involves tracking down fraud, supporting patients and prescribers, and improving practices. Concretely, the Cnam (National Health Insurance Fund) will contact:
All insured persons on sick leave for more than 18 months to check whether the sick leave is still justified or whether it is possible to adapt it with therapeutic part-time work or an organized return to work.
Insured persons who have had at least two absences of less than two weeks over a period of six months (except pregnant women, chronically ill people, etc.) to remind them of the rules and offer them support.
* 7,000 general practitioners who have fairly high prescription levels for a “fraternal exchange” to understand and see if they can contribute to better control of expenditure.
Additionally, Health Insurance will start sending its network of primary health insurance funds new “highly secure” sick leave forms, made available to doctors who request them. Their use will be mandatory from June 2025.
Visits to Companies
The Cnam will also organize visits to a thousand companies with a profile of “very high absenteeism” to check whether they are not creating conditions that lead to abuse of the system. This measure is designed to tackle fraud, which is a significant contributor to the increase in health expenditure.
Conclusion
Reducing work stoppage expenditure in France requires a comprehensive approach that involves tracking down fraud, supporting patients and prescribers, and improving practices. The government’s plan is designed to make the healthcare system more sustainable and equitable, and to ensure that it continues to provide high-quality care to those who need it.
References:
[1] https://www.thestar.com/news/world/europe/2024/09/10/france-health-insurance-expenditure.html
[2] https://www.allianzcare.com/en/support/health-and-wellness/national-healthcare-systems/french-healthcare-system.html
[3] https://en.wikipedia.org/wiki/Healthcarein_France
[4] https://www.ameli.fr/assure/english-pages
