The seven Primary candidates on the left answer Pourquoidoctor’s questions. On this day of the 1st TV debate, the series continues with the former Prime Minister Manuel Valls.
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.
But a few hours before the first televised debate organized this evening at 9 p.m. (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 Popular Alliance gives way this Thursday to the former Prime Minister Manuel Valls. In his project for France entitled “A strong Republic, a just France”, the candidate promises to strengthen our social and health model. Its slogan: “solidarity as the basis of dignity”.
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?
Manuel Valls : I will not let pharmaceutical companies take patients and health insurance hostage by their excessive pricing practices. We have shown with hepatitis C drugs that it is possible to control the cost of treatment, even if this requires tough negotiations. But it is true that our system must also be better prepared to absorb waves of pharmaceutical innovation. This is the meaning of the fund that has just been created within health insurance, dedicated to the support of innovative therapies. This is an important step forward, we will have to see if other measures are necessary so that no French people give up effective care because of their cost.
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 )?
Manuel Valls : The choice is not less solidarity or more tax! We have shown this over the past 5 years. We have reduced the health insurance deficit by 70% through unprecedented control of health expenditure. But these savings have never put the sick to contribution (no delisting, no new deductible, unlike the policy led by the right). It is an absolute red line that we have set ourselves, so that we have, at the same time, re-established our accounts and increased the share of health expenditure covered by social security. I want to continue along this path, one that brings solidarity and good management together.
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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?
Manuel Valls : Since 2012, we have made significant adjustments to the funding model of our hospitals; they made it possible to turn the page on “all-T2A”. Local hospitals now benefit from specific funding, independent of their activity. Funding for day care, critical care, such as resuscitation or intensive care, but also palliative care has also been adapted to move away from a purely quantitative logic. The share of funding earmarked for education and research has not only been secured but promoted. Hospitals today need stability, it is not desirable to constantly change the rules of the game.
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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?
Manuel Valls : It should first be remembered that there have never been so many doctors in France (198,000 in regular activity), but their distribution over the territory is often uneven, especially in a context of numerous retirements. I therefore want to continue to increase the number of doctors by removing the numerus clausus in medical studies. We will propose a proactive policy regarding the installation of doctors. These responses should be developed in close collaboration with professionals, who moreover increasingly want grouped methods of exercise, on the model of the nursing homes that we have been deploying throughout the territory since 2012: in 2016, nearly 90% of the new installations took place in a nursing home.
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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?
Manuel Valls : It’s an old debate that comes up regularly … I want to maintain a strong ban on the use of cannabis, quite simply because cannabis is a dangerous substance. Legalizing is not the solution! On the contrary, we must better protect, with a prevention policy aimed at the youngest, better identify addictive behaviors and better treat them.
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?
Manuel Valls : The question of recourse to medically assisted procreation for homosexual couples touches on complex, delicate ethical issues, such as that of filiation. You have to take the time to think it over. As I say in my draft, I will assume to open this debate. The role of the President of the Republic, as I see it, is to build a consensus, to guarantee that these debates do not damage the unity of the Nation.
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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?
Manuel Valls : I want to make environmental health a great national cause: we cannot stand idly by while urban pollution is the third cause of death in France. This will result in all the measures: incentives, particularly tax, so that old diesels (cars, buses, trucks) gradually leave our cities, increasingly ecological public transport, … The future lies with trams, electric buses and low emissions. I want to accompany this movement, support the French industrial sectors, which are very promising in the field.
(1) Thursday January 12: first 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 9 p.m. on TF1, RTL and The Obs.
Friday January 13, find our interview with Vincent Peillon
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