“My partner is Cuban, my Algerian health manager, one in two nurses in my clinic is not French, list Jérôme Marty, general practitioner and director of the Saint-Roch clinic in Fronton, Haute-Garonne. We are not going to deny the world in which we live! »
A few days before the second round of the presidential election, which will pit Emmanuel Macron against Marine Le Pen, some caregivers have multiplied calls, in the media and on social networks, not to be in the wrong fight. two grandstands, one in the Sunday newspaper, the other in Release, invite you to slip in a Macron bulletin, because the RN program poses many problems according to them.
“The abolition of the AME will distance many men and women from care”
If Marine Le Pen has refined a health program more generous than in 2017, some points, in fact, call out. Foremost among which is the abolition of State Medical Aid, which allows undocumented foreigners to benefit from free health care if they have resided for more than three months in France and if they do not exceed a ceiling of resources. More specifically, Marine Le Pen aims to reduce AME expenditure by 75% by replacing it with a system focusing solely on emergency care, except for minors (still beneficiaries of AME).
“Countdown to history after two years of pandemic, which have shown how much health and disease do not bother with passports. Costly idea too: at a time when we are pleading for more health prevention, reducing access to primary care will promote complications and, therefore, heavy, urgent and expensive care,” write the signatories of the forum published in the JDD. “The abolition of the AME will remove many very vulnerable men and women from care, warns Jérôme Marty. It is a rupture of fraternity which is not compatible with medical values. »
A discriminatory spirit contrary to humanist values
AME cost 920 million euros in 2020, or 0.4% of health expenditure in France. “It’s not much, insists Jérôme Marty, signatory of the tribune of the JDD. Focusing this aid only on emergencies will create expense, because these are poor populations, sometimes carriers of infectious pathologies, with a risk of a return or worsening of epidemics [tuberculose, IST…]. If these diseases are caught later, they will have more serious consequences. »
More generally, it is the discriminatory spirit defended by the RN that offends many caregivers. “The public hospital treats the poor and the rich in the same way, adds François Salachas, neurologist at the Pitié Salpêtrière hospital (AP-HP) and member of the Inter Hospital Collective. There is no sorting according to the origin of the patient, which honors France. »
How to meet the needs without foreign doctors?
A second point alerts some doctors. If Marine Le Pen is less clear in her program than Eric Zemmour was, she wishes “to open a sufficient number of places in the faculties of medicine to have the doctors that the French need, to absorb the medical deserts and to drastically reduce the recourse to doctors who obtained their diploma outside the European Union”.
A vague language for a somewhat contradictory project. Because without foreign caregivers, our health system would have even more trouble functioning. “It’s like in other professions: foreign doctors settle where French interns do not want to go, medical deserts, peripheral hospitals, supports Jérôme Marty. We can never thank them enough. Preventing new foreign doctors from settling in will further complicate the current challenge of replacing doctors who are retiring, or about to do so.
Are some doctors in office also at risk of being prevented from working? “I don’t think it’s a short-term risk,” said François Salachas, signatory of the platform in Freed “We, caregivers and activists of the Covid, will vote Macron despite our disagreements”. Even Eric Zemmour assured him: as long as we don’t have French doctors, we will keep the others. But if there is benchmarking in Europe on how foreign practitioners are attracted to deal with the recruitment crisis, it is not impossible. »
Especially since Marine Le Pen wants to impose the “national priority”. This means that a foreigner will have more difficulty obtaining a job or accommodation than a Frenchman. More than 10% of all practicing physicians have a diploma acquired abroad, whether they are French having studied elsewhere, foreign but belonging to the European Union or outside the EU. “This policy of stigmatizing foreign doctors risks, in the long term, making them leave, fears Jérôme Marty. However, Marine Le Pen does not explain how to run our peripheral hospitals, where between 80 and 90% of doctors are foreigners. This national preference would be deadly. »
How to finance new expenses?
Third problem: Marine Le Pen makes promises rarely funded. She planned to increase the salaries of nurses by 10%, to increase the schools of nurses and nursing assistants by 100,000 places, to recruit caregivers… Without specifying how. The one who posed as the candidate of purchasing power proposes to abolish the audiovisual license fee, to lower the VAT on energy from 20 to 5.5%, to abolish income tax for those under 30 years, of eexempt from employer contributions 10% increases in wages below 3 SMIC… According to Institut Montaigne, his program would cost more than 100 billion… against a figure of -13 billion according to the National Rally. “Although presenting itself under a social and protective aspect, there is nothing in the program to support that”, tackles François Salachas.
The fact remains that after months of alerts on a collapsing health system, a health crisis which has exhausted caregivers and a Ségur de la Santé which has disappointed many of them, some could be tempted to punish Emmanuel Macron . “Would those disappointed with Macron’s policy, who have humanist values, vote for Le Pen out of spite? I don’t believe in it much, nuances the neurologist. The risk of “white cap and white cap” exists. It was a bit the challenge of the platform: to fight against abstention. Nothing in Le Pen’s program gives the slightest guarantee that it would do otherwise, neither on the means, nor on the mode of dispatching these means. The RN has put on public service defense clothes to ride the wave of “yellow vests”. To see if Emmanuel Macron will have a gesture for caregivers by Sunday, like his late green shift.