Spend 40 euros per month (average cost in France), or almost 500 euros per year to benefit from additional health, a luxury? According to a study by the Drees (Department of Studies of the Ministry of Health) published last April, "more than 95% of people benefit from additional health insurance" in France.
But behind this rather reassuring figure hides a manifestly very different reality in Ile-de-France. According to the survey carried out by the Ipsos institute for the Parisien-Cosem * health barometer, 10.5% of patients have no complementary health in Ile-de-France. Worse: among those under 35, this rate rises to 15%! A figure that can only be found among the most modest socio-professional categories.
However, as Drees reminds us, "this second stage of health coverage, almost universal, plays an important role in access to care".
Who are these non-complementary?
Seine-Saint-Denis (15.4%) and Val-d'Oise (12.1%) are the most numerous, but more than one in ten Parisians (10.7%) ) has no additional. Overall, 21% are inactive, but 15.6% are employees and 14.7% workers to whom the employer, since the 2016 reform, must offer additional company support, with support for at least 50% of the cost.
Finally, 14.3% of the self-employed do not have a mutual fund, whereas, contrary to prejudice, only 5% of retirees do not have one.
This situation is all the more surprising since for the most modest, there is the CMU-C (complementary universal health cover), and the ACS (aid for complementary health), replaced since November 1 by the complementary health solidarity, including the cost varies between zero and 30 euros per month, depending on the income.
"It is not profitable"
A trainee civil servant, Augustin, 23, is one of these young people without any supplement. "A choice," he said. I count when I do my shopping, so I pay attention to this type of expenditure. At a minimum, he says, it would cost me 276 euros per year, it's a lot for me and I would be hardly better reimbursed. Because in France, unlike the United States where I lived and where I insured, health does not cost much. I know I am taking a risk, but with my budget constrained, and since I am in good health, a supplement is not profitable. "
What impact for these patients?
Our survey reveals that 36% of them have given up on optical equipment (glasses or contact lenses), largely subsidized by complementary health insurance. These patients are also those who consult their GP the least, of which they are reimbursed only at 70%, for lack of additional. They also go much less to the hospital, where the rest of their dependents can quickly climb. In short: they treat themselves less well.
* Cosem: the Coordination of social and medical works is an association created in 1945 which has 6 health centers in Paris (5th, 8th, 9th, 9th and 19th arrondissements) at opposable prices. It employs 700 health professionals and sees two million patients a year.
The Cosem - Le Parisien-Today in France survey was conducted by the Ipsos institute between October 25 and November 8, 2019 on the basis of a sample of 1,102 people aged 18 and over, living in Ile-de -France and representative of the population (according to the quota method), interviewed via the Internet.