The seven Primary candidates on the left answer Pourquoidoctor’s health questions. The president of the Ecologist Party, François de Rugy, starts the week.
After the success of the Primary of the right and the center (4.4 million voters in the second round) which crowned François Fillon, it is the turn of the French left to elect its candidate (January 22 and 29 2017) for the 2017 presidential election. And a change should be noted compared to the previous election, health is at the center of the debates. Health insurance, hospital … the French wanted to hear about it, they are served.
But a few days before the third televised debate (1), Why actor wishes to expand the list of medical subjects to be addressed (cannabis, environment, etc.). Our series of interviews with the seven candidates for the Primary of the Belle Alliance populaire begins the week with François de Rugy. The vice-president of the National Assembly claims that “Ecology is Rugy”. In his program for 2017, he also promises “France of all progress”. Does this ambitious slogan concern health? Reply.
The community will no longer be able to cover the cost of innovative drugs. Should we devote a specific budget to the support of these therapies, and how to finance it?
Francois de Rugy : This is of national solidarity, therefore of Health insurance which could in case of need to be supported by a very supervised grant of the State, after agreement with the pharmaceutical companies of so as to verify that costs are strictly controlled.
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Big and small risk
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To ensure the coverage of health expenses, should mandatory reimbursements be limited to serious and / or chronic illnesses (care basket), or rather act on funding by broadening the base of levies (for example with the CSG )?
Francois de Rugy : The principle of equal social protection for all in the face of disease must be reaffirmed. The distribution between health insurance and mutual funds must be maintained without being modified as proposed by François Fillon. I am also in favor of not focusing all the funding of social protection on wages by continuing the gradual shift towards CSG initiated by Michel Rocard and amplified by Lionel Jospin. Thus, I propose that the financing of the family branch of social security is thus assured, excluding the unemployed and small pensions. For employees, it will be, given of the increase of their net salary, a positive transaction. The family allowances will thus be financed by a contribution whose base, more broad, includes all the incomes, including those of the capital.
The hospital must simultaneously reconcile medical excellence with its social missions. In view of the budgetary constraints, does activity-based pricing (T2A) appear to you to be suited to this dual requirement?
Francois de Rugy : Yes, if the social missions are also listed in the framework of the “T2A” which should allow more transparent accounting of hospital, public, private profit-making or non-profit services (mutual clinics).
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Medical deserts
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One in four general practitioners will not be replaced by 2025. How do you plan to fight against medical deserts?
Francois de Rugy : I support the loosening of the numerus clausus in the faculties of medicine but that will put close of 10 years (time of training of physicians) to begin to show its effects. This is why I propose the creation of the status of professional of health of proximity. A medical master’s degree open to professionals of health with at least ten years of experience will be created. In return of the financial support of studies by the State, obligation will be made to graduates of settle in areas where people retire of non-replaced physicians are registered.
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Cannabis
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France is the European champion of cannabis consumption. It is also the country which has the most prohibitive law. Should we decriminalize use and should the State organize the production and distribution of cannabis?
Francois de Rugy : We must effectively decriminalize the use of cannabis, within the framework of state control. Within 18 months of the presidential election new legislation will be adopted. It should include three components: health, safety and economic. It will integrate an exclusive of the marketing of cannabis on the flow model of tobacco. Any sale outside of this controlled network will remain illegal. This device will be valid for five years – time to measure its effects – period after of which is a law drawing lessons of the experiment and correcting any adverse effects observed would be adopted, or we would revert to current legislation.
In a manifesto, French doctors admitted having helped lesbian couples and single women to resort to assisted reproduction abroad. Can we continue to reserve it for heterosexual couples?
Francois de Rugy : For parenting projects made easier for all, I support an opening of assisted reproduction to all women. Today, it is open to women in heterosexual couples in a situation of sterility, assisted reproduction with anonymous donor will be available to all couples, including couples of women. No discrimination will be established for its coverage by social insurance.
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Environment
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What would be the first concrete measure you would take to limit the harmful effects of pollution on our daily lives? And when?
Francois de Rugy : The first measure will be to put in place a multi-year plan for “0% carbon transport in 2025” which will set milestones: from 2018, large urban areas will have the legislative and regulatory tools to limit the circulation of diesel vehicles, the marketing of which will be banned in 2025. The goal is for France to target sales of new 100% electric or hybrid-electric cars by 2025.
It is important that financial support for electric vehicles be maintained during the transition period and that specific advantages be granted to fuel-efficient cars and car-sharing (parking, highway tariffs, reserved lanes).
(1) Thursday, January 19: third debate of the Citizen Primaries. The 7 candidates, Jean-Luc Bennahmias, François de Rugy, Benoît Hamon, Arnaud Montebourg, Vincent Peillon, Sylvia Pinel and Manuel Valls will debate at 8:55 pm on France 2 and Europe 1.
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