A dose of resistance and tightening of the classic bolt: health insurance presented, Thursday, July 7, 30 measures to reduce the cost of 1.2 billion euros next year, which will not be enough to meet the double-digit deficit. Not yet out of Covid, the National Health Insurance Fund (CNM) aims to save half of the target two billion a year before the health crisis – with a total expenditure of about 230 billion. A sign of the executive’s new priority, its traditional “Expenditure and Products” report for 2023 gives a proud place to resist – now attached to the Ministry of Health title.
Since the end of September, Cnam has placed special emphasis on heart failure with a “warning signal” and a desire to generalize remote monitoring of 300,000 most “severe” patients. Remote monitoring for diabetics is also promoted through digital tools (apps, connected devices) or Sophia telephone support services to avoid disease complications.
Overwhelmed by the health insurance file and late to pay compensation
Promise of campaigning
Health Insurance also seeks to compensate for delays in cancer screening (colon, breast, uterine) and human papillomavirus (HPV) vaccinations for adolescents over the past two years, although this means sending a list of doctors. Their infected patients. Other proposals echo Emanuel Macron’s campaign promise, such as “systematic identification of visual and linguistic disorders for all 3-year-olds” – the re-elected head of state called for “early identification of differences in development”, regardless of age. If this bet of resistance is supposed to have “long-term effects” (the benefits of the 2017-18 anti-influenza campaign are estimated at about 50 million), these new methods make “by pathology” or “population-based” a minority of projected savings for 2023 ( 160 million euros) does not represent.
Targets large portions (750 million) such as general medications (less antibiotics, more biosimilars), medical devices (sleep apnea, dressings), work stops or even medical transportation. An extended effort against fraud and abuse of caregivers (300 million) has also been announced, including better “shipment control” and new “measures against misguided dental centers”. The “damage” review, which began in the spring, will continue with a particular focus on nurses, among others, by the end of the year, with other assumptions on prospective pharmacists, physiotherapists and doctors expected.
Anxious weight of “chronic disease” at the expense of health
A series of tight discussions
Meanwhile, Health Insurance is taking advantage of its annual report to set a number of milestones ahead of a series of tight talks. The “high” margins of biological analysis laboratories, raised by the health crisis, are thus put forward to justify price revisions at the beginning of the school year. The same calendar and the same procedure for dentists: willing to expand “100% health” for orthodontics, Cnam highlights the additional fees and income of relevant professionals. Similarly for doctors, who have to amend their contracts with Social Security: their income, but above all the growing costs of their prescriptions have been analyzed in detail.
In exchange for new “assignments of work” to paramedics and “advanced advice” from experts in the medical desert, the fund though is willing to pay more medical assistants to physicians without the presence of physicians and provide an extension to solve the problems of 6 million insured. But in the end, the proposed treatments will not cure the deep illness health insurance of the deficit dug by Covid: after the abysmal record of 2020 (-30 billion) and 2021 (-26 billion), the damage should still reach 19. Stay billion this year and over 13 billion next year and beyond. A new hardening cure has been dropped, the remedy still remains to be invented.
But why do shared medical records remain empty shells?
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