François Fillon: “There is no question of penalizing a person who has an addiction”

While the right and center primary for the presidential election will take place on November 20 and 27, the time for the first of the three televised debates is fast approaching. Lasting 2h30, it will take place on October 13 on TF1, RTL, Public Senate and LCI. It will see the seven competitors compete on the themes of unemployment and security. And what about health?

In a recent survey, 69% of French people make this theme a major element of the campaign. And almost the same proportion of respondents consider that the positions of the candidates on health policy will be decisive in their choice.
To meet the expectations of future voters, the drafting of whydoctor interviewed all the candidates by asking them the same questions.
The first to issue his prescription for the future of the French health system is former Prime Minister François Fillon. The Sarthe man is often presented as the 3^th man in the polls, behind Alain Juppé and Nicolas Sarkozy. Opening of PMA, support for therapeutic innovation, medical deserts, he answers all our questions.

The community will no longer be able to bear the cost of innovative drugs. Should we devote a specific budget to the management of these therapies, and how to finance it?
Francois Fillon : Pharmaceutical laboratories are developing, based on academic research, drugs with unprecedented actions that constitute a real therapeutic breakthrough. We should rejoice. The corollary of being “innovative” in the field is today “expensive” and the question of the long-term sustainability of the expenditure incurred for our health system is indeed raised. Whether the budget is specific, sanctuarized or not, it will weigh in the same way on all expenditure.
What matters is to define the right price with the manufacturers. Several elements could be taken into account: a share of the savings in expenses incurred, the number of years of life gained by taking into account the quality of life of the patient treated and the share of the laboratory’s turnover transferred to its R&D. Let’s not forget that support for French research and innovation is essential in order to maintain our health sovereignty.

Medication What matters is to define the right price with the manufacturers.

Complementary Health are committed to an à la carte insurance model. Should we financially encourage policyholders who have a healthy lifestyle (diet, physical activity, etc.) and/or penalize those who take risks (alcohol, tobacco, etc.)?
Francois Fillon : Our health is our most precious asset. Very often, however, we are not aware of its fragility. In this sense, health education is a major issue. It should start at an early age. Should we nevertheless go further and empower policyholders to have a healthy lifestyle? Yes, and the financial incentives are a lever.
On the other hand, there is no question of penalizing a person who is addicted to tobacco, alcohol or other. The answer is more medical than financial. We should add, however, that in the fight against smoking, increasing the price of a pack of cigarettes remains the most effective action.

Supported There is no question of penalizing a person who has an addiction.

The hospital must both reconcile medical excellence with its social missions. Given budgetary constraints, does activity-based pricing (T2A) seem appropriate to you for this dual requirement?
Francois Fillon : Health establishments, whether they belong to the public or private sectors, whether the latter is for profit or not, must present medical excellence in terms of quality and safety. It is a requirement of our care system.
Public and private non-profit establishments are more effectively carrying out public health and innovation actions that include in particular the care of patients in precarious situations. These actions are financed by the MIGAC allocations, Missions of General Interest and Aid for Contracting, the amount of which is discussed annually.
Remember, however, that the public hospital is in crisis. Nursing staff are harassed by difficult working conditions partly linked to unfilled positions, 35 hospital hours, the lack of attractiveness of hospital careers and sometimes violent tensions with certain patients and their relatives. A national hospital plan is to be implemented.

medical deserts We need financial incentives to encourage the installation of doctors.

One in four GPs will not be replaced by 2025. How do you intend to fight against medical deserts?
Francois Fillon : It is a paradoxical situation. If there have never been so many doctors trained in France, the medical time available has never been so low. The next generation no longer wants to work 60 hours a week and I understand that. Doctors are drowned in paperwork. Administrative costs represent around 15% of a doctor’s day. The generalization of third-party payment will not help matters! Practitioners must be helped to set up a medical secretariat, financial incentives are needed to encourage them to set up.
Finally, one figure is very surprising: while the university trains 7,500 new doctors a year, nearly 2,000 (25%) do not register with the Council of the Order. Understanding why these young doctors do not practice is essential because they can be a response to our under-resourced territories in particular. This is all the more essential when 85% of those enrolled in the 1st year of medicine will not be received in the second year.

Assisted reproduction The Republic cannot deliberately give birth to children without a father.

In a manifesto, French doctors acknowledged having helped lesbian couples and single women to resort to PMA abroad. Can we continue to reserve it for heterosexual couples?
Francois Fillon : Some doctors refer their patients to centers for Medically Assisted Procreation (MAP) outside our borders. Female couples and single women know how to go directly to ART centers abroad.
I expressed myself in my Families and Solidarity proposals on access to ART. ART is a medical response to couples of different sexes faced with medical infertility.
The Republic cannot deliberately give birth to children without a father. The interest of the child must prevail. On the other hand, it is necessary to know how to welcome children born when they have no responsibility in the origin of their birth and to give them legal stability, stability which does not however require full adoption.

Tomorrow find our interview with Bruno Le Maire