The seven Primary candidates on the left answer Pourquoidoctor’s health questions. The president of the Democratic Front, Jean-Luc Bennahmias, continues the series.
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 – on January 22 and 29 – its candidate for the 2017 presidential election. And a notable change has taken place 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.
Our series of interviews with the seven candidates for the Primary of the Belle Popular Alliance continues this Tuesday with Jean-Luc Bennahmias, president of the Democratic Front, Ecological and Social. Does anyone who wants to “modernize and rejuvenate French democracy” share the same ambition for the French health system?
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?
Jean-Luc Bennahmias : The innovative drugs of today are the common drugs of tomorrow. There is therefore no reason to penalize them, otherwise medical progress would be either delayed or reserved for the richest. “Innovative” drugs must therefore be treated like any other.
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 )?
Jean-Luc Bennahmias : There is no reason to give up Social Security, as it was put in place after World War II by the government of national unity led by Charles de Gaulle. Funding arrangements that broaden the foundation on which our health care system rests, such as the CSG, allow the system to function properly, except during times when mass unemployment is exceptionally high. Pharmaceutical companies must, when essential, participate in the effort required of all.
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Hospital
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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?
Jean-Luc Bennahmias : Activity-based pricing is obviously still necessary and prices must be regularly adjusted to the rapid development of technologies and treatments. But this activity-based pricing must be extended to a new internal management that will encourage efforts to improve quality and productivity. The real problem of the public hospital is an interventionist, vertical governance, fragmented by professional sectors, which has disempowered and demotivated doctors and caregivers. A new co-management bringing together general management and services is absolutely essential to regain dynamism and confidence.
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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?
Jean-Luc Bennahmias : Many local communities, especially in the rural world, where this problem is more acute, have decided to help set up nursing homes that allow the different medical professions to be accommodated in the same place, with management commune (reception, secretary, rent). This track seems to me the most fruitful, and is already giving good results.
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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?
Jean-Luc Bennahmias : I am in favor of the controlled legalization of cannabis and its derivatives. As with tobacco and alcohol, the ban on minors will remain. Many states, in America, as in Europe, have legalized its cultivation and distribution, without seeing consumption increase. The creation in France of an office responsible for the distribution of this product, as for tobacco, will make it possible to put an end to a number of trafficking and to organize reasoned prevention. The justice system, the police, the gendarmerie, will thus be able to devote themselves to more pressing issues for the community.
Medicinal cannabis will be managed by the medical professions, under the same conditions as poppy derivatives today, for comparable uses. For substitute uses for other drugs, the procedure will be done under the same conditions as for synthetic drugs (Subutex, methadone).
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?
Jean-Luc Bennahmias : The question of the relationship with the child is not a medical problem, but a problem of a social project. The child should not be a comfort aid for any couple. Anthropological questions prompt us to have an in-depth, reasoned debate on these topics, addressing all aspects of the problem, and not just the medical act of ART. However, we should not be guided by a backward or moral view in these areas. The key question is the ability to provide the child with a framework for sustainable development that is as stable as possible.
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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?
Jean-Luc Bennahmias : One measure would not be enough. One of the priorities will be to switch from international freight transport to piggyback and / or combined transport, as Switzerland and Austria have already done. The legislative and regulatory elements to organize this passage will be taken in the first 6 months of the quinquennium.
Wednesday January 11, find our interview with Arnaud Montebourg
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