Negotiations are slipping between liberal doctors and Social Security. The two main unions among general practitioners and specialists announced Sunday evening their “unanimous” rejection of the new consultation rates proposed for five years by the Health Insurance, in return for a commitment to increase their activity. The six representative doctors’ unions have until Tuesday evening to say whether or not they accept this new fee schedule.
“There was 98% participation and 100% said no to signing. A unanimous negative vote “which” must be such as to make politicians think, “said Agnès Giannotti, president of MG France, the largest union of general practitioners. Same result among specialists from the Avenir Spé-Le Bloc union, meeting in a general meeting on Sunday: “No signature, unanimously”, indicated the president of Avenir Spé, Patrick Gasser. “We did what we could, it’s a failure,” he added, but “the responsibility lies with others, in government and above.”
Practitioners denounce a “lack of recognition”
The proposal of the National Health Insurance Fund (Cnam) provides that all medical consultations would be revalued by 1.50 euro. For general practitioners, this unconditional revaluation would bring the basic consultation to 26.50 euros, against 25 euros since 2017. Practitioners agreeing to make “territorial commitments” (taking more patients, participating in on-call duty, practicing in a medical desert …) would obtain a higher consultation rate, at 30 euros for example for general practitioners.
But among general practitioners, this question of the tariff was “marginal” in the outcome of the vote, assured Agnès Giannotti, explaining that practitioners mainly suffer from a “lack of recognition”. “To say that we have to get involved means that we don’t do it and that is absolutely inaudible for the profession,” she added.
For the specialists, the counterparties required were simply “not admissible”, explained Patrick Gasser, comparing the overall envelope of 1.5 billion euros advanced by the Cnam to the “billions injected into health establishments, public and private” since the Covid-19 and the “Ségur de la santé”.
With this rejection of the two organizations weighing more than 30% each among generalists and specialists, the draft agreement supported by the government is about to fall through. In the absence of an improbable alliance between at least two of the four remaining unions, the new tariffs will be fixed by an “arbiter” – in this case, a senior official appointed by the executive. The Ministry of Health has planned to speak on the subject this Monday in the middle of the morning.