The cost of a medical consultation will eventually increase by 1.50 euros, decided the mediator Annick Morel, former inspector general of social affairs in charge of the file after the failure of negotiations between Health Insurance and the unions of doctors at the end of February. According to the new “arbitration rules” presented this Monday, April 24, general medicine consultations will reach 26.50 euros minimum (instead of 25 euros) and 31.50 at specialists (instead of 30).
These revaluations must still be validated by the Minister of Health François Braun, but should come into force by the fall “at the end of a period of six months“.
A standoff for several months
In February 2023, the two main doctors’ unions announced that they had “unanimously” rejected the agreement proposed by the National Health Insurance Fund, which proposed to increase the consultation to 30 euros, in return for carrying out a ” territorial commitment contract”, i.e. additional commitments, particularly in medical deserts. For those who did not accept them, the Cnam offered a increase of €1.50, i.e. a consultation at €26.50. A “humiliating” proposition for many concerned.
If this revaluation of 1.50 euros had already been proposed to the unions of the profession at the beginning of February, the Cnam had only unveiled Thursday, February 23 this measure of “territorial commitment contract” (CET) which aims mainly to respond to the problem of medical desertification in particular by carrying out guards, as well as to relieve emergencies. A measure that had aroused the dissatisfaction of doctors: “With this territorial commitment contract, we are creating something artificial, which leads to paying more than the basic rates of doctors who agree to overload themselves with work.told AFP Dr. Raphaël Dachicourt, secretary general of ReAGJIR, a union of young doctors.
It rested on three main measures :
- The increase in medical supply, i.e. the size and evolution of the patient population;
- Financial access to care, respecting the rates for sectors 1 and 2);
- And finally, the response to the needs of the territory, particularly within the medical deserts.
But finally, “no revaluation subject to a territorial commitment” was ultimately retained in the agreement proposed by Annick Morel.
What other measures have been taken?
The mediator has chosen to keep measures dear to the executive, in particular the expansion and relaxation of financial assistance for recruitment: Emmanuel Macron wishes 10,000 jobs by the end of 2024, compared to just over 4,300 today. This decision will apply immediately.
Annick Morel has also announced that she wants “sustain” incentives for liberals who participate in the “regulation” Samu telephone service (100 euros per hour) and to receive patients within 48 hours (15 euros increase). The “initial registration consultation” for a person with a long-term condition who does not have a treating doctor will be paid up to 60 euros. A measure that concerns approximately 700,000 patients.
But what do the doctors’ unions think? “These arbitration rules are very light, and that’s good“, rejoiced a union source with Capital. “Mless there are things in this regulation, the better it is to relaunch negotiations with Health Insurance as soon as possible“, she continues. “If we could resume in June, that would be good.“, says Dr. Jérôme Marty, head of the UFMLS, at the Parisian.
