The National Health Insurance Fund (Cnam) proposes that the consultation with the general practitioner, currently at 25 euros, increases to 30 euros for practitioners who will accept additional commitments against medical desertification, she indicated Wednesday evening.
For doctors who do not accept these commitments, the consultation would be set at 26.50 euros, she said.
The Caisse and its general manager Thomas Fatôme began a final round of negotiations on Wednesday afternoon with the unions of liberal doctors to try to reach an agreement on the prices of consultations for the next five years.
The CNAM had already unveiled to the doctors' unions its proposal for a revaluation of 1.50 euros in the prices of consultations, thus bringing the basic consultation of general practitioners to 26.50 euros.
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But she had not yet unveiled her proposal for general practitioners agreeing to engage in a
“territorial commitment contract”
, which aims to increase the supply of care by doctors, in particular to respond to the problem of medical deserts. .
The territorial commitment contract asks doctors to commit to three subjects:
"increasing the medical offer (size and evolution of the patient population), financial access to care"
(compliance with sector 1 tariffs or of sector 2), and
“the response to the care needs of the territory (participation in the permanence of care, unscheduled care, coordinated exercise)”,
indicated Thursday evening the Cnam to AFP.
The unions demand a better revaluation
"This proposal confirms the will of the Health Insurance to respond to the problem of access to care for all, by strongly supporting the liberal doctors who are committed to this same approach, in the logic of 'give-and-take'. '”
she clarified.
The doctors' unions are demanding a general increase that is much more substantial than the 26.50 euros proposed by the Cnam, to at least 30 euros, or even 50, without signing new commitments.
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"With this territorial commitment contract, we are creating something artificial, which leads to paying more than the basic rates of doctors who agree to overload themselves with work", explains in particular
Dr. Raphaël Dachicourt, secretary general of ReAGJIR, a union of young doctors observing in the negotiations.
The negotiations, which take place at the headquarters of the Cnam in Paris, were still in progress Wednesday in the middle of the evening.
They are due to resume Thursday afternoon.
The Cnam and the doctors' unions must have signed the new medical agreement next Tuesday at the latest, otherwise the new agreement will be drafted by an arbitrator, Annick Morel, a former general inspector of social affairs.