“The consequence of the government’s budgetary choices is the financialization of health care provision”

2024-10-11 13:00:00

The Social Security financing bill (PLFSS) 2025, presented Thursday, October 10, primarily targets the health sector, both on moderating spending and increasing revenue through social contributions. Among the measures, the public reimbursement rate for medical consultations should fall from 70% to 60%, for a saving of 1.1 billion euros. In addition to this dangerous and ineffective measure – no restructuring of the health system has been announced – the rest of the savings will be made by reducing the prices of health services and products, mechanically worsening the crisis in the health system.

This transfer to mutual insurance companies has already taken place for dental care in October 2023, with harmful consequences for policyholders. Public reimbursement was reduced from 70% to 60%, for a saving of 500 million euros per year. Supplementary health insurance contributions then increased by 10% in 2024, an overall increase of 4 billion, instead of 1 to 1.5 billion per year in previous years. This disproportion between constrained private spending and saved public spending (in a ratio of 5 euros for 1 public euro saved) is the sign of a profound dysfunction of the private market, where the opacity of information distorts competition and transforms the captive user as a cash cow for operators.

Among other things, the share of management costs of complementary insurers has not declined for ten years (it exceeds 20% of contributions): it has further increased by more than 8 billion in 2023. Thus, for an amount of 10 euros reimbursed through their supplement, the insured pays 3 euros in management fees, compared to 30 cents for public health insurance. The main victims of this disproportionate increase are middle-class retirees, who finance 100% of contracts whose costs are three times higher than those of active workers, the latter bearing only 50% of the burden, another aberration of the system.

The financialization of primary care provision

The cost of a health contract represents more than a month’s pension for them, with no guarantee of access to specialists, who are poorly covered by the majority of contracts taken out. Before the announcement of the PLFSS 2025, the planned increase in contributions to supplementary insurance was of the order of 8% for 2025, or 150 euros per retiree and 3.5 billion euros overall. If this new transfer is voted on, the increase will well exceed 10%, approaching 250 euros per retiree and 5 billion in total. This constrained expenditure will be added to the six-month deindexation of retirement pensions in 2025, provided for by the 2025 finance bill.

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