Question 10208 — maternity health insurance

Summary

Mr. Julien Guibert draws the attention of the Minister of Labor, Health, Solidarity, Families, Autonomy and People with Disabilities to the worrying consequences of the gradual dereimbursement of numerous preventive or supportive treatments, combined with the discussions currently being carried out on the reform of the long-term illness (ALD) regime. In a context of tension on public finances and then even that the French are experiencing persistent inflation and a decline in purchasing power, the policy of refocusing reimbursements initiated by the Government could, in the short term, weaken the most vulnerable patients and, in the medium term, result in much higher additional costs for the community. This concerns in particular so-called “comfort” treatments, the effectiveness of which is nevertheless recognized in the prevention or therapeutic support for serious pathologies: supportive treatments for patients with cancer, medical injections against obesity, or even certain practices from alternative medicine. However, these treatments are increasingly subject to dereimbursement by social security, with charges being transferred to complementary health insurance. At the same time, several avenues mentioned by the Government aim to restrict access to the long-term illness regime, in particular by excluding certain patients in remission or by tightening the eligibility criteria. These directions risk having dramatic cumulative effects. People on ALD today represent 20% of the population but account for more than 66% of health insurance spending. Their support costs on average 9,560 euros per year, compared to 1,230 euros for patients outside ALD. The slightest weakening of this regime, combined with increasing out-of-pocket costs for essential treatments, could significantly increase the number of people foregoing care. The pathologies would worsen, the use of emergency services would become more frequent, hospitalizations more numerous. However, a single day of hospitalization can cost between 1,300 and 3,000 euros, or even more in intensive care. The economy in the short term on certain reimbursements could thus turn into an explosion of expenses in the following years. Under these conditions, the MP wishes to know what guarantees the Government intends to provide to maintain fair and sustainable coverage of preventive and supportive treatments and to preserve the spirit of the long-term illness regime, the cornerstone of health solidarity. national. Finally, he asks him what quantitative assessments his services have been able to carry out regarding the delayed impacts of these measures on hospital expenditure and social accounts.

Machine translation from French. The official text remains authoritative.

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