The price negotiation session with the liberal doctors' unions, which was to take place this Thursday, will be held on another day. Two unions of liberal doctors, Avenir Spé Le Bloc and the UFML-S announced during the night from Wednesday to Thursday that they were suspending their participation in these discussions with Health Insurance, in support of private hospitalization which denounces the weakness of the tariff increase granted to it for 2024.
Faced with this situation, Health Insurance therefore announced this Thursday morning the postponement of this meeting with the liberal doctors' unions. “Thomas Fatôme, general director of the CNAM, is forced to postpone” the negotiation session scheduled for Thursday April 5 after the decision of two unions not to attend, Health Insurance indicated in a press release. In addition, he “deplores the delay in the conclusion of the conventional negotiations”.
In the meantime, the two unions have called on liberal doctors to join the call for a strike by private hospitals and clinics starting June 3.
“Liberal medicine is under attack”
“The government's decision to increase funding for private for-profit clinics and hospitals by 0.3%” while public hospitals will benefit from an increase of 4.3%, “is unacceptable for independent specialist doctors who practice in these structures,” indicated the Avenir Spé Le Bloc union, the first among specialist doctors.
“Each doctor must understand that it is liberal medicine which is attacked, threatened in its very existence, through the orchestrated destabilization of private hospitalization,” indicated the union of general practitioners UFML-S.
The three giants of private clinics, Elsan, Ramsay and Vivalto, asked the government on Thursday to “review its copy” concerning hospital pricing which gives pride of place to the public sector and which risks, according to them, leading to a “reduction in costs”. care ". “We are asking that the government review its copy. We collectively ask to be received and listened to” by the Ministry of Health, declared Sébastien Proto, executive president of Elsan during an unprecedented press conference with his competing counterparts.
An increase of 3.2% requested
“If we wanted to erase the consequences of inflation, we would have had to increase prices by 10%” in 2024, estimated Sébastien Proto. Without going that far, private establishments are demanding a 3.2% increase in their prices, so that “2024 is not another year of profound deterioration”. “The more we treat, the more we work at a loss, it’s untenable”, due to “inflation which has not been compensated”, said Pascal Roché, general director of Ramsay Santé. Together, the three competitors provide “40% of cancer treatment each year,” he added.
The decision to “underfund” private health centers, which are very present in the territories, will result, according to them, in increasing medical deserts. The consequences will also be economic, according to Sébastien Proto: “There will necessarily be restructuring” from this year and a decline in investment capacity to support modernization. The three groups have 300 hospitals in total in France, 5 million patients treated, 60,000 employees including 16,000 private doctors and nearly 500 million euros of investment each year.
End of home visits for SOS doctors
For its part, SOS Docteurs fears that the current price negotiations between Health Insurance and the unions of private doctors will lead “straight to the end of home visits” for the famous association. “Already today, daytime home visits are greatly compromised, due to failure to find willing doctors to carry them out. Many doctors prefer fixed-point consultations, which are financially two to three times more attractive,” explained SOS Médecins. “Discussions with Health Insurance seem to be leading to a widening of this gap,” she added. “Under these conditions, the home visit will not survive the summer,” she predicted.
The share of home visits has already been considerably reduced since the beginnings of SOS-Médecins in 1966, when they then constituted all of the actions of member doctors. This reduction accelerated from 2019, and today, home visits only represent a third of their activity. SOS Docteurs calls for “the establishment of a penalty of 100 euros per hour” for doctors available to make home visits on call from the Samu or the access to care service (SAS), the new 15 which redirects certain patients to community medicine.