After the seventh 49.3 of the fall and the rejection of the motion of censure of the Nupes, it is official: the Social Security financing law for 2023 was adopted by the National Assembly late Friday evening.
Falling deficit, free morning after pill, rising tobacco prices… Overview of the main measures.
Savings
If the Social Security budget does not provide for a planing stroke on the hospital, savings are still expected in several sectors.
About 1 billion euros must be earned on the side of drug reimbursements, 250 million on analysis laboratories, 150 million on imaging, and as much on complementary health.
This is a little less than originally expected.
Faced with the revolt of drug manufacturers, the government backed down in mid-October on certain measures that would constrain them.
The analysis laboratories remain, for their part, upwind against the requested puncture.
They are on strike until Saturday.
Read also95% of analysis laboratories closed: unprecedented strike, headache for patients
Another way to spend less: the government plans, with this text, to deepen the fight against fraud.
From 2024, non-pension allowances can no longer be paid into non-European bank accounts.
A new source of savings, work stoppages prescribed by teleconsultation by a professional other than the treating doctor or a doctor seen in the last 12 months will no longer be reimbursed.
Optimistic assumptions for the deficit
Since the abyssal record of 2020 (nearly 39 billion), the losses have been reduced, to less than 25 billion in 2021. For this year, they were programmed at 17.8 billion.
But Assembly and Senate voted on the government's proposal for extensions for the hospital, in particular to deal with the epidemics of bronchiolitis and Covid, which brings the projected deficit to 18.9 billion.
For 2023, it should be 7.1 billion, if the government's optimistic assumptions are confirmed.
Accentuated prevention
To fight against social inequalities in health, prevention consultations will be offered at key ages in life (20-25, 40-45 and 60-65).
These meetings should also be "the place to identify sexist and sexual violence", added the deputies.
The text also plans to make it possible to screen for certain sexually transmitted infections without a prescription for everyone, and free of charge for those under 26.
In addition, emergency contraception will be free for all women, without medical prescription.
Compulsory screening for sickle cell disease in newborns will be experimented for three years.
If successful, it could then be extended indefinitely.
Rising tobacco prices
The average package price, currently 10.15 euros, should rise to 11 euros in 2024, depending on inflation.
Taxation on tobacco brings in between 13 and 14 billion per year, against a cost of 20 to 26 billion euros for health insurance.
Complementary and repair
Among the changes to note, the law on financing the Social Security budget provides for simplified access for young people and the elderly, under certain conditions, to complementary health insurance.
In another area, compensation will be improved for children suffering from a pathology due to the occupational exposure of one of their parents and compensation will be extended to the rightful claimants.
Changes for caregivers
Several measures in the Social Security budget concern doctors.
On the training side, the internship for general practitioners will be extended by one year, with internships outside the hospital and "as a priority" in medical deserts - deputies from all sides pleaded for an obligation - to better train them in the liberal exercise and accompany their installation.
Read alsoMedical deserts: "The purpose of the internship in general medicine is not to compensate for the lack of access to care"
The possibility for doctors and nurses to work until the age of 72 in hospitals will be extended until the end of 2035. This measure was put in place in 2015 in order to absorb a “demographic shock in public health establishments”.
It was normally due to end on December 31, 2022.
Combining employment and retirement – which allows the retiree to resume or continue a professional activity and to accumulate income – will be possible for health professionals in medical deserts.
In addition, liberal doctors in this situation will be exempt from old-age insurance contributions under an income level fixed by decree.
Due to the lack of on-call doctors throughout the territory on evenings and weekends, it is planned to extend the “permanent care” to nurses, midwives and dentists.
Another change, pharmacists and nurses will be given the ability to prescribe vaccines.
And midwives will be able to vaccinate more people.
Young caregivers will no longer be able to work on a temporary basis as soon as they leave school, but must first practice “in another framework”, salaried or liberal, “for a minimum period” which will be fixed by decree.
Temporary work is becoming more and more expensive for hospitals.
The issue of nursing homes
Some 3,000 nurses and nursing assistants will come to reinforce the staff of retirement homes, the first stage of a plan of 50,000 additional recruitments by 2027. There will be added 4,000 additional places in home help services.
In response to the scandal that erupted in the Ehpad of the Orpea group at the start of the year, the requirements on the transparency and financial regulation of medico-social establishments and services are supplemented by the text.
VIDEO.
Lack of hygiene, balanced meals, medical monitoring… Olivia Mokiejewski denounces the reception conditions of many nursing homes
In addition, the national "floor rate" per hour of intervention by home help services is raised to 23 euros in 2023. It had been set at 22 euros since the beginning of 2022.
Thumbs up for parents
The financial assistance paid to families who have their child looked after by a childminder will be reassessed, so that their remaining dependents are the same as if the child benefited from a place in a crèche.
Single-parent families will now receive financial assistance for childcare until they enter college, and no longer until the start of CP.
And the minimum alimony paid to them by the CAF in the event of default by the other parent will be increased by 50%, from 123 to 185 euros per month.
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