According to Igas, the completion of the dematerialization of Social Security services can generate € 542 million in savings per year. Another avenue, removing the delegation of management to student mutuals.
The health insurance deficit could reach 41 billion euros in 2040, and 49 billion in 2060. In this context, theGeneral Inspectorate of Social Affairs (Igas) published a report containing measures to be implemented to reduce the management costs of compulsory and complementary health insurance. Conclusion of the Inspection, it would be possible to generate “savings of 1.7 billion euros per year by 2020”.
Here’s how.
Over 12 billion in management fees
First of all, the Igas reveals that the management costs of the compulsory and complementary schemes reached the sum of 12.5 billion euros in 2012. With a very complex system which is based on “a significant institutional fragmentation”. Because to manage the 14 compulsory health insurance schemes, France has in fact no less than 86 operators. The three main ones are the CNAMTS (employees), the MSA (agriculture) and the RSI (self-employed and craftsmen). But alongside them, there are 11 special regimes, organizations delegated to the general system (for students or civil servants) and the 20 RSI approved organizations.
Finally, this “institutional breakdown” is also found for complementary health insurance, with around 682 operators for complementary organizations.
For the end of the delegation to student mutuals
Track suggested by the Igas therefore to generate savings: bring together these organizations, with the key to a sharp reduction in the number of stakeholders. As such, the Inspectorate affirms that this reorganization around two large management operators would be likely to bring savings of the order of 440 million per year.
But to go even further in the reorganization of the system, the Igas considers that the delegation of management granted to student mutuals (LMDE, SMEREP) should also be abolished and this function returned to the general system. This measure would save nearly $ 44 million.
In the same vein, the Igas recommends reintegrating the management of civil servants and affiliates (covered by the local mutualist sections) within the primary health insurance funds.
Many retirements planned
Another lever offered by the Igas is to speed up the electronic management process for treatment sheets and invoices. The medium-term savings could amount to 542 million per year for the compulsory general scheme and 344 million for the complementary health insurance.
Finally, the Igas mission makes several proposals to reduce the wage bill without dismissal. With 49% of staff over 50 at the end of 2012, the mission estimates that 28,000 will be retiring by 2020. “This is the last window allowing both to make gains productivity by simply not replacing certain departures and systematically and fully reclassifying all the workforce affected by structural reorganizations, ”the authors conclude.
As a reminder, the government of Manuel Valls has set the objective of achieving savings of 21 billion over three years on health insurance.
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