Question 8296 — health establishments

Summary

The Government wanted, for reasons of fairness, to display identical rates of change between sectors and between categories of establishments before taking into account the mechanisms for exemptions from charges and tax credits and prudential reserves. Taking into account the rate of change in the national health insurance expenditure objective (ONDAM) 2018 voted by Parliament as part of the health insurance financing law, social security (LFSS), the gross rate of change in hospital rates for medicine, surgery, obstetrics (MCO) is therefore -0.5% for all sectors, more favorable than that of 2017 (-0.9%). To this gross rate of change common to all then applies the prudential coefficient of reserve (-0.7%) as well as for each category of establishment, the coefficient of recovery of exemptions from tax credits with regard to of the amount of exemptions received. This concerns in particular private non-profit establishments which have benefited from the Wage Tax Credit (CITS) since 2017. Since 2013, the reductions in charges from which certain private health establishments benefit have been taken into account within the framework of tariff and budgetary constructions. The State was thus led to take into account the impact of the tax measures of the Competitiveness and Employment Tax Credit (CICE) and the responsibility pact for all sectors. In 2017, the CITS was established for private non-profit establishments using a system similar to the CICE. Therefore, in the interest of fairness between hospital sectors, it was necessary to provide the same mechanism for resuming these reductions in charges within the framework of tariff constructions. The -2.7% change in Prices of non-profit establishments in the sector take this price construction mechanism into account. It must be analyzed taking into account the evolution of credits specific to non-profit establishments in this sector, and which represents an increase of 1% in the prices of these establishments. The -2.7% change in published prices therefore actually corresponds to a -1.7% change. Finally, the Government is fully aware of the role that private non-profit establishments play in the healthcare system and the constraints weighing on health establishments including private non-profit establishments. This is why the Minister of Solidarity and Health wanted to initiate a real transformation of the entire health system because the reforms to be undertaken can only be part of a global approach. To bring out the solutions proposed by stakeholders in the field, consultations were organized in five major structuring projects, including a project exclusively devoted to the reform of the financing of health establishments. The main directions of the transformation strategy of our health system resulting from these consultations must be implemented under the best conditions and as soon as possible. THE The challenges for our health system are major, in order to face today's challenges and prepare the health system of tomorrow, always placing the patient at the center of future developments.

Machine translation from French. The official text remains authoritative.

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