Generalized third party payer: why doctors are against

The Health Insurance today pays the liberal doctor directly, without advance of costs for the patient, when the latter is covered by the CMU or AME (State medical aid): it is the third party payer. And this mechanism constitutes the phrare measure of the next health bill which provides for the extension of third-party payment to the entire population. A measure that is not to the taste of all health professionals.

Liberal doctors fear for their fees
For example, liberal physicians in particular fear an impact on their fees. “The consultation (in general medicine) is 23 euros. (…) Tomorrow, if you impose the generalization of third-party payment, it will have to be cut from management fees of 2 euros 50 per act. (…) Will the third-party payment result in a reduction in the price of consultations, which is already so low in our country? This we cannot accept! », Recently confided to why actor Dr Jean-Paul Ortiz, president of the main union of liberal doctors, the CSMF (1).

Doctors also doubt the feasibility of implementing this measure. “The mandatory third-party payment, which will be impossible to implement technically, although the services of the Ministry of Health claim, will be a source of multiple errors, undoubtedly to the detriment of doctors, ”the union affirmed.

Social justice for Marisol Touraine
A point that Marisol Touraine is happy to design. The Minister admitting in fact that the “technical challenge” of the device will be “very important”. Regarding doctors’ fees, the Minister wanted to be even more reassuring by reaffirming that she wanted “the risks of cash flow or administrative burden to be totally controlled, both for doctors and for paying agencies. “
But for the minister, this reform must above all “allow people to no longer postpone their care or to no longer give up for financial reasons”, she stressed on numerous occasions. Currently, 35% of city medicine acts are paid for through third-party payment.

Finally, Mariosl Touraine reminded these doctors that cases of forfeiture of care for financial reasons do not only concern people below the poverty line (namely 982 euros per month). “There are also people who have more income than that and who have difficulty making ends meet. I cannot accept the idea that these people would delay their visit to the liberal doctor for treatment, ”insisted the minister.

La Mutualité Française favors third-party payment
For his part, the president of the Mutualité Française, Etienne Caniard, wishes to “tackle the subject of third-party payment” to which he is in favor. “A simple, modern, effective and providing a guarantee of payment to health professionals”, according to him.

To reassure the latter, Etienne Caniard undertakes to simplify all administrative procedures as much as possible, “because it is clear that doctors are there to treat their patients, not to fill out papers,” he said.
To prove his goodwill, the president of the FNMF indicates that he has written to his counterparts at the French Federation of Insurance Companies (FFSA) and the Technical Center of Provident Institutions (Ctip) with a view to formulating with software publishers simple and neutral proposals for doctors, which will be ready in 2017, when the device is generalized.

“With third-party payment, mutuals already prevent their members from advancing 6.8 billion euros each year,” he argues. Tomorrow, with generalization, it would be 11.2 billion in advance of costs which, instead of being extracted, could be left at the disposal of the French to revitalize the economy, ”he concluded.

The French support the generalization of third-party payment
Finally, the French are in favor of this provision. According to a survey (1) revealed a few days ago in The Parisian and produced by OpinionWay for the liberal doctors’ union SML, two out of three French people approve of generalized third-party payment, the opposite of doctors. The latter were in fact overwhelmingly opposed (95%).

(1) Confederation of French medical unions