Dominique Viot: 'The TSA tax, a subject of intense debate'

The response of Dominique Viot, president of the Délégation du Var of the Mutualité Française. In response, the government is asking them to 'give the money back' to the State via an increase in the Taxe de Solidarité Additionnelle (TSA), which weighs on health insurance contracts. 'The increase in the TSA, a sort of VAT on health, would further burden the purchasing power of the French, particularly those who need care the most and have the fewest resources. The TSA imposes a role on mutuelles that is not theirs: collecting tax, whereas their primary mission is to cover risks, insure and protect their members,' explains Dominique Viot.

STRUCTURAL FACTORS

He continues: 'The rise in contributions for mutuelles for 2025 is explained by several structural factors. First of all, by the continuous increase in health expenditure for more than 10 years (+4% in 2022; +5.2% in 2023). Then, the aging of the population, access to new treatments and technologies, and the fair recognition of healthcare professions (for example, the revaluation of the general practitioner consultation fee to €30). We must also take into account the increase in benefits paid by complementary schemes, notably due to the 100% Santé reform, new benefits such as the commitment to oral prevention, and the financing of new treatments. Finally, there is also the expenditure reimbursed by complementary schemes which increases more sharply than all medical expenses, and the fair share of health expenditures (+4.3% in 2022; +6.4% in 2023). The president of the Délégation du Var resumes his argument: 'Any increase in the taxation of complementary health contracts proportionally increases their cost, weighing on the purchasing power of those who subscribe to them. Currently, the TSA is equivalent to 13.27% of the amount of contributions for responsible contracts (95% of the market), i.e., two months of contributions for members. In comparison, health contracts are exempt from tax in Germany or taxed at 0.15% in Spain. Contributions for complementary health insurance are higher for people covered by an individual contract (mainly retirees, young people before employment, and the economically inactive), as they do not benefit from employer support or tax exemptions. The increase in the TSA will impact them more heavily, increasing their level of contribution, particularly that of retirees, who have the highest contributions.'

THE PROPOSITIONS OF THE MUTUALITÉ

For the Mutualité Française, there are other ways to achieve savings. It advocates for a more efficient, better-planned healthcare system that is more focused on prevention, notably by establishing a multi-year framework in the organization and financing of the healthcare system (optimizing, anticipating, and making our system readable). Representatives of the mutualist world are ready to define its outlines and practical terms. And, by accelerating the preventive shift underway towards a more efficient and fairer operation. This preventive dynamic must be facilitated by the use of increasingly precise data and the recourse to artificial intelligence... for 'tailor-made' medicine for every socially insured individual, every patient.