It’s time to save money. In an attempt to control Social Security spending, the executive is considering doubling the amount of medical deductibles. Since 2008, the year it was introduced, this sum, deducted from health insurance reimbursements for medicines, has been 50 euro cents (2 euros for medical transport), within the limit of an annual ceiling of 50 euros. per person.
Why does the government want to increase this deductible to 1 euro? With what consequences? Does the executive have other levers to make more significant savings? For 20 minutesFrédéric Bizard, professor of economics at ESCP and president of the health institute, delivers his analysis of the reform that he considers “very fragile politically”.
Why does the government want to double the amount of medical deductibles?
The goal displayed by the executive: “to save money” to “guarantee the financing of Social Security”, indicated this Friday the Minister of Public Accounts Thomas Cazenave. As reminded France 3the reimbursement of drugs cost Social Security 26 billion euros in 2022, and expenditure is up by more than 7% in the first half of 2023. By raising the amount of the deductible to 1 euro, Bercy hopes to recover between 500 and million euros, as exposed The world.
“From a budgetary point of view, it is extremely effective, notes our specialist. It is not a painless but invisible measure for the insured. This is not an expense for the insured, it is a lower reimbursement. But Bercy is trying to dress it up as a public health measure. Rather than restructuring funding by making it clearer, we are making it more complex. This is debatable on the health and social level. »
To achieve its ends, the government could also play on the ceiling (€50) by deciding to raise it. “Either we increase the deductible and not the ceiling, or we increase both”, confided to the Parisian a source familiar with the matter.
What consequences would an increase in deductibles entail?
“Since 2017, we have increased access to health, glasses, audio prostheses, dental care, we continue to finance health accessible to all, but we must also, in responsibility, sometimes find new sources of financing. to guarantee our model”, explained Thomas Cazenave.
The risk is that such an initiative rests on the shoulders of the middle class. “The only people who reach the ceiling are those who suffer from long-term conditions, for example neurodegenerative diseases such as Alzheimer’s, who are often over 65 years old. In this target, the most affected will be those who will be part of the basic middle class. From this point of view, the measure is antisocial, ”slices our expert.
Ségur is working on an “accountability system that does not penalize patients with long-term illness”, blew the entourage of the Minister of Health Aurélien Rousseau at the World. As a reminder, in France, 11 million policyholders benefit from long-term illness status, according to health insurance.
What are the other levers to achieve more significant savings?
The government does not refrain from touching the flat-rate contribution to the doctor, or from including in the medical deductibles products that are not concerned. According to Frédéric Bizard, for the state to be able to lower the rating, it is necessary to tackle “structural reforms”. “If we go from a system with two funders (health insurance + complementary health insurance) to a single funder, we could significantly reduce administrative expenditure and improve readability”, recommends the economist.
Another lever: dereimbursing drugs with low medical service (reimbursed at 15%) or moderate (30%). “There would be substantial savings to be sought, and private insurance contracts are free to decide to reimburse them”, delivers the specialist. The government will present its Social Security financing bill at the start of the school year, and may, in the event of a lack of majority, use 49-3.