2024-07-26 02:30:08
Liberal doctors unhappy with the conditions of their practice, who threaten to break contracts that cover them in health insurance? The National Health Insurance Fund (CNAM) has just pulled the stick: a so-called “unconventional” practitioner – one who freely sets prices outside the traditional system – may find that tomorrow, their patients will no longer receive Reimbursement of prescription drugs (drugs). Furthermore, patients who consult these private doctors in Region 3 today already pay for the consultation (reimbursement ranges from €0.43 to €1.22).
The threat remains entirely theoretical: the measure is one of 30 recommendations contained in the 2025 “Expenditure and Revenue” report released on July 18. Or health insurance’s annual contribution to the Social Security Financing Act (PLFSS), whose parliamentary review must begin in the autumn, which should identify sources of savings for the sector. However, health insurance is cautious not to quantify the expected benefits of such reimbursements, assuming that what matters at this stage is symbolic measures.
Only 743 professionals – including 527 general practitioners, 62 surgeons, 48 psychiatrists, etc. – practice outside the traditional framework. Data transmitted by CNAM will be reported to approximately 110,000 approved GPs and specialists, including 79,000 GPs in Sector 1 (without excess fees) and 32,000 doctors in Sector 2 (agreed with excess fees cost).
“Necessary clarification”
Why approve this shocking proposal, which is both unexpected and divisive, and which seems anecdotal given the proposed savings of 1.56 billion euros in health insurance? At a time when the “Secu” deficit exceeds 10 billion euros, CNAM is taking responsibility: it is not so much an economic measure. “Needs clarification” Faced with practitioners who do not want to play the medical covenant game, the covenant ties them to health insurance.
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The new version of the text, initialed on June 4 by five of the six unions representing urban medicine, was approved after 18 months of intense negotiations, among which the French Free Medical Union (UFML-S, only non-non-medical Alliance) threatens deregulation. About 5,300 “Statement of Intent” Its president, Jérôme Marty, points to the reasons for deconventionality.
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