Question 13524 — health

Summary

Mrs. Sandrine Nosbé draws the attention of the Minister of Health, Families, Autonomy and People with Disabilities to the increasingly alarming situation experienced by many patients living in rural, urban and peri-urban areas of the department of Isère, under-resourced in medical presence and where the absence of general practitioners associated with the coordinated care pathway heavily penalizes the inhabitants. On his constituency, medical desertification has become an unbearable reality. According to the new zoning of the Isère Regional Health Agency put in place on January 1, 2026, 41 of the 70 municipalities in the constituency of the MP are classified as ZIP: priority intervention zones, that is to say areas where the tension in terms of access to care is the most dramatic. She highlights the alarming example of the municipalities of Saint-Marcellin and Tullins, respectively the third and fourth most populated municipalities in its constituency, falling under the ZIP, which, concerning the municipality of Tullins, was not the case during the 2022 zoning. With 20 other municipalities placed in fragile zones that are the ZAC (complementary action zones), almost 90% of its constituency is not sufficiently provided with general medicine. Thus, as everywhere in France, the supply of general practitioners is rapidly deteriorating in the 9th district of Isère. However, under the social security code and in accordance with the coordinated care pathway, recourse to a specialist doctor requires prior passage by a treating doctor for optimal reimbursement. The inhabitants of his constituency who already cannot find a treating doctor are thus doubly sanctioned in that patients, particularly from the working classes, precarious workers, low-income retirees and the chronically ill, bear more of the costs of a medical desertification that they did not choose. This financial penalty which reduces their reimbursement when they are considered “off-course” is part of the paradox of a public health service imprisoned in a logic of the market and profitability. In view of these elements, she asks when she plans to include in the law a system of exemption from any financial penalty for patients residing at least in ZIPs, whether they are located in Isère or throughout France and overseas.

Machine translation from French. The official text remains authoritative.

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