Will the latest proposals from the National Health Insurance Fund (Cnam) for doctors be accepted by the unions of practitioners? On the eve of very tense final negotiations, the director general of the Cnam, Thomas Fatôme, sent Tuesday to all the doctors a letter summarizing his proposals on the revaluation of their tariffs.
An agreement must be reached before the deadline of February 28, but the unions are currently refusing his proposals. They oppose in particular the will of the Cnam to reserve its most attractive proposals only to doctors who have signed a Territorial Commitment Contract (CET). A contract intended to fight against the effects of medical desertification and asks practitioners for commitments intended to improve the supply of care: increase in their patient base, opening on Saturday mornings, employment of a medical assistant, collaboration with a nurse in practice advanced…
Question about the price of the consultation
“With this CET, we are creating something artificial, which leads to paying more than the basic rates of doctors who agree to overload themselves with work,” said Dr. Raphaël Dachicourt, secretary general of ReAGJIR, a union of young doctors. observer in the negotiations.
The amount of the basic consultation offered to doctors who agree to sign a CET has not yet been revealed by the Cnam. But for all those who refuse to sign, it offers a basic consultation at 26.5 euros, against 25 euros currently. A “provocation” for the unions, who expect no less than 30 euros. The Cnam argues that the revaluation to 26.5 euros represents “on average an annual increase of 7,000 euros” in the fees of a general practitioner. All doctors will also benefit from certain upgrades, such as those related to the status of attending physician, or “on average 2,000 euros per year”, according to the Cnam.
In the absence of an agreement on February 28, the Cnam will apply for the next five years the provisions of arbitration rules, which will be drafted by Annick Morel, retired general inspector of social affairs. Many doctors – nearly 10,000 according to the organizers, 4,500 according to the police – had demonstrated on February 14 in Paris against the proposals of the Cnam, but also against various legislative proposals which cut into the prerogatives of doctors (freedom of installation, access directly to the care of nurses or physiotherapists, etc.).