Poor organization of care, costs of technical progress, aging of the population … By 2040, the health insurance deficit could reach the bar of 40 billion euros.
The health insurance deficit could reach 41 billion euros in 2040, and 49 billion in 2060… These astronomical figures came out of the calculators of the Top advice for the future of health insurance (HCAAM). The experts of this body, made up of representatives of unions, employers and the administration, published at the end of December their projections on the evolution of health spending until 2060.
According to their scenario, the share of total health expenditure in GDP increases by 2.8 points, reaching 13.1% in 2060. That of reimbursed expenditure increases by 2.3 points (10.4% of GDP in 2060 ). The problem is that over this same period revenues hardly increase. Thus, the deficit increases throughout the period, going from -0.4 point of GDP in 2011 to -2.4 points in 2060. Its increase is significant between 2011 and 2020 (+0.3 point of GDP) then s’ increases until 2040. The balance deteriorates at a slower pace from that date (-0.4 point in 20 years, from 2040 to 2060, against -1.4 point between 2020 and 2040).
In question, the progress and organization of care
The reasons for this increase in the deficit are known. First, the aging of the population. It will cause an increase in long-lasting ailments (ALD). According to experts, if the rate of individuals in ALD was 15.9% in 2011, it could be between 18.7% in the optimistic scenario and 20.1% in the pessimistic scenario in 2060. Thus, the expenditure of individuals suffering from ALD which represented 58.1% of total expenditure in 2011 would represent 62.7% of total expenditure on care in 2060.
The second and main reason for the deficit for the HCAAM, “technical progress and the organization of care appear to be major contributors to health expenditure”.
Scenarios for reducing the deficit
Faced with these expected phenomena, the HCAAM notes three solutions: increase social security contributions, increase the delisting of care, and finally the one preferred by the HCAAM experts, “energetic and permanent” control of health expenditure. The HCAAM therefore pleads once again for a better organization of primary care. A solution that should be included in the national health strategy announced by Marisol Touraine last fall. A solution encouraged by the President of the Republic. Indeed, during his vows, François Hollande promised “savings wherever they are possible”, insisting in particular on “the excesses and abuses” concerning Social Security.
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