Dominique Viot: "Let's reduce the Sécurité Sociale deficit by acting on its efficiency"

In the draft bill for the financing of the Sécurité Sociale (PLFSS), complementary health insurance providers must shoulder nearly 20% of the savings announced by the government to reduce the Assurance Maladie deficit in 2025. Hence the question: "How will those insured under social security be affected?" Indeed, Michel Barnier revealed what everyone suspected: France's accounts are in a very bad state and it is not going to get better! Efforts must therefore be made to restore the accounts.

MORE EXPENSIVE MEDICAL CONSULTATIONS

The cost of a medical consultation rose from €26.5 to €30 on November 1, 2024 (it was €25 at the beginning of the year). In the PLFSS, the government plans a new transfer of charges by increasing the ticket modérateur from 30 to 40% on consultations. As of 2025, complementary health insurance providers will have to cover €12 per consultation, instead of €7.5 currently. "The increase in their coverage will then be 60%," warns Dominique Viot. Mechanically, this transfer of expenditure will affect the wallets of French citizens, but it will not solve the underlying problem of the social protection system. Thus, with the increases in coverage for medical consultations, an out-of-pocket balance of €1.1 billion will have to be paid by social security beneficiaries. "However, for many years, healthcare expenditure has been constantly undervalued to hide the huge deficit of the Sécurité Sociale. Yet, factors such as the rise in healthcare consumption and the aging of the population remain unavoidable," recalls Dominique Viot. He adds: "Mutual insurance companies are obliged to balance their books; they will have no choice but to pass this transfer on to contributions." But every year, as non-profit organizations, our financial results are barely balanced (between 0.1 and 0.2%) and contributions are set in line with increases in healthcare expenditure. Such a measure affects the entire population and more particularly people who consult doctors frequently, such as seniors or people suffering from a long-term illness (ALD). Indeed, ALD patients benefit from full coverage by the Assurance Maladie only for care and consultations related to their ALD. Another point denounced by the Var official: "The PLFSS provides for a reduction in the ceiling for daily allowances paid by the Sécurité Sociale in the event of sick leave from 1.8 to 1.4 SMIC. This saving measure, which should yield around €600 million, will lead to an increase in welfare benefits, without acting on the drift of benefits. Moreover, with a €5 increase in medical consultations and mutual coverage rising from €7.5 to €12, it is the complementary health insurers who are financing 90% of the price increase for medical consultations." Yet, this is not the first transfer of expenditure to complementary providers. Already in 2023, €500 million was transferred when the ticket modérateur went from 30 to 40% for dental care. In reality, these transfers operate under a communicating vessels logic between public expenditure and private expenditure, but they do not solve the underlying problem and do not address the need for structural reform.