Establishing new medical pricing, reviewing the contribution to the CNSS, promulgating a code of medical responsibility, these are the main demands of private doctors. To make itself heard, the Collective of Liberal Doctors sent correspondence to the Ministries of Health and Justice as well as to the CNSS, demanding their urgent intervention in order to rectify the situation.
Doctors in the private sector are returning to the charge, expressing their fears about the problems the sector continues to face. This is how the National Collective of Liberal Physicians sent various correspondence detailing the constraints that private medical practices face.
Outdated pricing
Doctors mainly deplore the degraded financial situation of medical practices. A decline in revenues has been noted in recent years, compounded by an increase in management costs as well as heavy and varied tax charges. The imposition of contributions to the National Social Security Fund (CNSS), which liberal doctors consider unfair, remains significantly higher than that imposed on other liberal professions. Another major concern is outdated reference pricing. They point out that the latter has not been updated for 18 years, which makes it unsuitable.
“It harms both the doctor and the citizen, who is reimbursed on this basis. In this context, any improvement in the effectiveness of compulsory medical coverage necessarily requires an urgent review of this pricing, as well as an increase in the share of coverage of medical costs by the CNSS, to bring it up to 70%. at 80% or even 90%, particularly after the integration of the civil service into the said regime,” specifies the collective.
The hegemony of certain investors in the private medical sector, the appearance of unethical practices and the proliferation of unfair competition constitute other grievances. Liberal doctors point to the disorderly opening of the private sector to public sector doctors, in a clear legislative vacuum, while awaiting the promulgation of laws governing the partnership between the public and private sectors. This situation mainly benefits certain investors in the private sector, to the detriment of medical practices already burdened by significant management and tax costs.
For the collective, medical practice in the private sector is becoming a simple business, due to the desire of certain investors to dominate the market and eliminate their competitors. Unethical practices have appeared, in full view of everyone, without forgetting the emergence of associations practicing “connecting” insured patients to certain clinics, without making them bear their share of contribution. This constitutes a flagrant violation of the law and unfair competition, requiring urgent intervention from the supervisory ministry.
Medical liability
As for social coverage, the collective submitted a complaint to the CNSS, calling on the administration to carry out an urgent review of these contributions, as was previously promised to the signatory unions. An agreement – which also includes incentive measures, including, among other things, partial coverage of medical coverage costs – was mentioned.
Liberal doctors also drew attention to a practice consisting of validating requests for care, without carrying out a prior verification of the national identification number. An act which opens the door wide to the illegal practice of medicine and unfair competition. The demands are not limited to the health sector. Liberal doctors have demanded the promulgation of a Code of Medical Responsibility from the Ministry of Justice.
This code, which would regulate practices and responsibilities in the field of health, like many other countries, would make it possible to avoid resorting to the Penal Code to judge doctors regarding “complications” that occurred during exercise of their profession.
“In the current situation, marked by a legal vacuum, proving a medical error requires medical, technical and legal research. Recourse to jurisprudential interpretation and arbitrary assessment of compensation can lead to harsh judgments as well as amounts of compensation that may be surprising. The urgency of addressing this issue is all the more evident as our health system is undergoing significant changes, particularly with the establishment of new laws,” says the collective of private doctors, which insists on the definition of responsibilities and obligations of each party, as well as the need to distinguish between a complication, an incident, a medical error and a criminal act.
The nature and extent of the damage should also be specified. An approach which would make it possible to regulate the amount of compensation and avoid arbitrary assessments, as is already the case for the codes governing road or work accidents.
Maryem Ouazzani / ECO Inspirations
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