2023-07-19 22:00:00
The summary
Organizations and funds financed by basic compulsory schemes (Offrob) form a heterogeneous category of agencies, establishments and funds financed by social security and having a certain autonomy to implement specific aspects of health policy.
Numbering fifteen in 2023, the Offrobs include Public Health France, the National Agency for the Safety of Medicines and Health Products (ANSM), the Compensation Fund for Asbestos Victims (Fiva), and the High Authority for Health (HAS).
The financial effort of the health, accidents at work and occupational diseases and autonomy branches in favor of Offrob reaches considerable amounts: 6.7 billion euros in 2022, i.e. an amount more than half of the credits of the “Culture” mission of the general budget.
The basic compulsory schemes play a decisive role in the financing of health agencies: their endowments represented, in 2022, 78 percent of the products affected by the Offrob.
Funding by social security implies, for the Offrobs, a derogatory circuit with respect to State operators, via the social security financing law (LFSS): the credits granted are evaluative and not restrictive, and the allocation to eleven of the fifteen Offrobs is only subject to an implicit vote of Parliament.
This gave rise to serious breaches of the principle of parliamentary information, with the allocation by simple ministerial decree and without informing the competent committees of 4.8 billion euros of exceptional allocations to Public Health France, a practice all the more questionable as part of this subsidy was used to supplement the general budget.
Despite the essential role of the Offrobs in health matters, the insufficient involvement of Parliament in determining the allocations allocated to them also prevents parliamentarians from defending the means granted to these agencies, some of which appear to be underfunded.
The mission of information proposes to reform the budgetary procedure applicable to Offrob for a more democratic decision and a more effective management.
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