In 2019, 5.4 million French people did not have a attending physician. Faced with the shortage of general practitioners, Social Security will set up a system allowing them to no longer be sanctioned.
In France, since 2004, the reform of the coordinated care pathway requires each insured person over the age of 16 to declare a general practitioner to the Health Insurance before consulting a specialist and to benefit from a reimbursement at the full rate.
However, faced with the shortage of general practitioners in certain regions, many French people have still not declared any attending physicians. According to Nicolas Revel, Director General of the National Health Insurance Fund, there would be 5.4 million not to have a declared doctor in 2019. “Among them, a proportion of rather young and healthy patients did not seek to find one,” he told the trade journal The Generalist. But “more than half of our fellow citizens without a general practitioner are actually looking for a regular practitioner, often because they have not been able to find one when their GP retires.” According to a survey by the UFC-Que Choisir association published in November, 44% of general practitioners refuse to become the doctor treating new patients.
The double jeopardy of patients without an attending physician
Unfortunately, the trend is unlikely to reverse. In question: the increase in medical deserts throughout France. According to The Parisian6,500 fewer general practitioners since 2010 are practicing in France, despite an increase in the number of trained practitioners.
Result: not only is it difficult today for millions of French people to find a general practitioner, but their reimbursements are reduced: 30% of the Social Security reimbursement base instead of 70% for each consultation with a general practitioner or specialist.
An injustice of which the National Health Insurance Fund is well aware. Joined on Monday by the editorial staff of ParisianNicolas Revel indicated the forthcoming implementation of a system “so that these patients who have lost their general practitioner, or tell us to seek one, are identified and that their consultation is well reimbursed without application of a penalty, i.e. up to 70% of the reimbursement base and 100% for people with long-term illness or pregnant women.”
Exceptions provided
Be careful however: this device can only be applied if the patients are able to prove that they have indeed lost their doctor or that they are actively looking for one. For others, the reimbursement of a general practitioner consultation in sector 1, billed at €25, will only be covered up to 30%, i.e. €7.50 reimbursed instead of €17.50.
Exceptions are provided for, in particular for consultations with specialists already accessible outside the care pathway: gynecologists, ophthalmologists, psychiatrists, neuropsychiatrists and stomatologists. Up to the age of 16, children are also reimbursed up to 70%.
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