While the Social Security financing bill (PLFSS) 2025 continues its examination – it arrived for discussion before the Senate on Monday, November 18 – the government has just clarified its intentions on one of the savings measures the most sensitive: the increase in user fees. One of the avenues mentioned so far was to change this amount remaining the responsibility of the patient, but covered by complementary health insurance (in the majority of contracts), by increasing it by 10 points. While Health Insurance today reimburses 70% of a medical consultation, when mutual insurance companies cover the remaining 30%, there was talk of a new 60%-40% ratio. All this, in order to generate 1.1 billion euros in savings, as part of this transfer from compulsory health insurance to supplementary health insurance, in a context of a significant deficit in Social Security.
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At the opening of the debates in session, at the Palais du Luxembourg, on Monday, the Minister of Health, Geneviève Darrieussecq, moved the lines: the user ticket “will only change by 5%” for medical consultations, but “in addition, [celui] on medicines will increase by 5% »she said. The other change announced concerns the amount of expected savings, “reduced from 1.1 billion to 900 million euros”specified the minister.
Coverage of consultations by Health Insurance would thus increase to 65%. For medicines, the existing reimbursement rates – 65%, 30% and 15%, depending on the medical benefit rendered – would a priori be lowered in the same proportion. These future developments do not appear as such in the draft Social Security budget: they come under the regulatory level (ministerial decrees). The planned deadline is 2025, with no further details at this stage.
“Planer blow”
For example, today, for a medicine reimbursed at 65%, such as an antibiotic (on prescription) at 7.95 euros, the patient remains responsible for, in addition to the deductible (1 euro), a co-payment of 2.78 euros (35%), reimbursed in part or in full by complementary insurance, depending on Health Insurance.
The subject may seem technical, but it has already caused a reaction from patient associations and doctors' unions, opposed to this increase. In the ranks of mutual societies, we were also moved by what passes for a “plane blow” of a magnitude “unpublished”likely to lead to increases in contributions for policyholders. One year after the controversy over the doubling, effective in March, of “medical deductibles” – these amounts payable by the patient when he buys a box of medicine (from 0.50 euros to 1 euro) or consults a doctor (from 1 euro to 2 euros) – the future evolution of the user ticket also fueled fairly unanimous political opposition in the ranks of parliamentarians who examined the PLFSS in the National Assembly in October.
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