“The structural issues of our social protection system are not inevitable”

Tribune. Since 2019, the High Council for the Future of Health Insurance (HCAAM) leads discussions on the question of the link between Social Security and complementary health insurance.

This body, which brings together more than sixty actors from the world of social protection and which produces analyzes and opinions prior to legislative work, is subject, in a pre-electoral context, to a politicization of its debates which is not conducive to their good completion.

However, the HCAAM is a place of collective intelligence where the actors are not in the conflict but in the search for common solutions for the benefit of the general interest. The signatories reaffirm the interest of such a body, necessary for the health democracy of our country, and strongly condemn the instrumentalisation. They want future work to regain the serenity necessary for the quality of opinions.

Vain controversy

While the remainder to be paid by the French is the lowest in Europe, a heated controversy swells over one of the scenarios that this body documents, that of a nationalization of the complementary health, known as “great Security”. So as not to get lost in a futile controversy, we wish to reaffirm the issues facing the French and our health system.

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The debate on the link between social security and complementary health insurance is relevant when it calls for answers to real questions, such as, for example, the excessive weight of the cost of health in the budget of certain households.

But this debate and certain overly simplistic solutions do not respond, far from it, to the daily difficulties experienced by the French. Medical deserts, lengthening of the delays to obtain an appointment with a general practitioner or specialist, deep crisis in the hospital subject to dramatic recruitment difficulties, insufficient support for loss of autonomy: these are the main immediate challenges , priorities, which they are confronted with in order to access healthcare.

We must, moreover, get our health system out of the ruts from which it has not been able to extricate itself for too long: insufficient complementarity between city care and the hospital, excessively in demand, system excessively organized around care to the detriment of prevention, around the belief in the omnipotence of a central State to the detriment of the formidable potential of actors in the field: local communities, patient associations, health professionals, social partners, complementary health … A central State which, faced with the increase health expenditure under the weight of the aging of the population, the development of chronic diseases and technical progress, only finds accounting solutions – or recourse to social debt – to temporarily hide the deficits it generates structurally.

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