2024-09-25 12:30:04
The Jean-Mermoz private hospital – Ramsay Santé, in Lyon, May 20, 2022. LAURENT CERINO/REA
“Financialization of healthcare provision”: the expression may seem technical. However, today, it refers to one of the major concerns in the world of health, that of seeing new private players investing in the care sector, at the risk of market abuses.
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To shed light on the current movement, an information mission from the Senate Social Affairs Committee, led by a trio of parliamentarians – Bernard Jomier (Place publique, Paris), Corinne Imbert (Les Républicains, Charente-Maritime) and Olivier Henno (Union of Democrats and Independents, North) –, has just made public, Wednesday September 25, a report providing a first important inventory on the subject. The title, although formulated in an interrogative manner, sets the tone: “A takeover bid for health? »
In certain sectors, the “toggle” is already widely engaged, note the authors in this 256-page report: this is the case of for-profit clinics, where four large groups concentrate almost half of the French market (Ramsay Santé, Elsan, Vivalto and Almaviva). Same thing for biology laboratories, identified as “most financialized sector” on the urban healthcare side, around a few large groups (six of them currently accounting for two-thirds of the sites). A sector in full swing “arm wrestling” with Health Insurance: many medical biology laboratories went on strike from September 20 to 23 to contest the application of lower prices.
“Black box” for public authorities
In other areas, this movement started more recently, but is accelerating. Medical imaging, which is experiencing very active dynamics, would be “financialized” to the tune of 20% to 30% of the sector, but also health centers, primarily dental and ophthalmological, pharmacies, and even care centers. primary (those which bring together general practitioners), for which interest from investors (Ramsay Santé, Ipso) has recently been developing.
The rapporteurs place their magnifying glass on this transformation of a “so-called professional capitalism”in which doctors, pharmacists, biologists, etc. retain control of the means of production of practices and clinics, towards a “financialized capitalism”where outside investors take financial and strategic control of companies.
And after? If the report mentions an investment « rentable » et ” on “ for private groups, with valuations which can reach, for example in the imaging sector, thirteen to fifteen times the gross operating surplus, he mentions, with regard to the remuneration of these actors, a “black box” for public authorities. And widely questions the capacity of the supervisory authorities, regional health agencies (ARS) and Medicare, to control this process, “compliance with the criteria of accessibility, quality and relevance of care”.
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