In response to accusations, Marisol Touraine indicates that the coverage by Social Security has increased and that the remainder of the charge for patients is decreasing.
Since April 1, 2015, coverage by complementary health insurance for excess fees for physicians has been limited. Ditto for optical expenses now regulated.
These new rules have entered into force within the framework of so-called “responsible” contracts. In this agreement, the government grants, on the one hand, reduced taxation to insurers and mutuals, on the other hand, these organizations undertake to respect criteria to lower certain tariffs for health professionals.
For the first time, insurance companies and mutuals are obliged to offer limited coverage for glasses, for example, and to cover the daily hospital rate without a time limit. But will this system really benefit patients or backfire?
With the National Interprofessional Agreement (ANI) that followed, many experts feared that the millions of employees concerned would soon discover that important services, such as dental or optics, would be very poorly covered or that the their contribution amount will increase as of next year.
Le Figaro said on Tuesday that “the Touraine reform increases the bill for patients”. But in a press release published a few hours later, the Ministry of Health formally denied these accusations. Supporting figures.
Better management of social security
Marisol Touraine recalls that “contrary to certain press statements”, French healthcare coverage has improved, from 77.2% in 2011 to 78% in 2014.
At the same time, the tenant of avenue Duquesne maintains that the share payable by households, after intervention of the Health Insurance and complementary insurance, has decreased: “it went from 9.1% in 2011 to 8, 5% in 2014 ”. A gain in purchasing power of more than 1 billion for households, according to the minister.
In addition, the latter recalls that medical deductibles have been abolished for the 1.2 million modest insured beneficiaries of supplementary health assistance, and that the government has introduced 100% coverage for several procedures ( contraception for minors, abortion, etc.).
Decreasing fee overruns
In addition, the government affirms that the overruns of physicians’ fees have fallen since 2012. While it had fallen from 38% in 2000 to 56% in 2011, it fell to 53% in 2015. “This is due to the strong determination on the part of the government and the commitment of a growing number of professionals in access to care contracts which, in exchange for lower prices, make it possible to better reimburse patients, ”explains Marisol Touraine. “A third of the doctors in sector 2 are involved in this process,” she adds.
In praise of responsible contracts
Finally, the latter writes that before the reform of responsible contracts, 34% of contracts concluded with complementary health insurance only covered the daily hospital fee for a limited period, “leaving high costs to be borne by patients in the event of long stay in hospital ”.
But it indicates that today, only 12% of policyholders pay overruns going beyond the regulated reimbursement ceilings. “This means that they pay for care at rates that are 2, 3 or even 4 times those of health insurance,” she explains. Proof that there is still work to be done in providing access to healthcare for all? Not really for Marisol Touraine who corrects: only a part of them anyway benefited before the reform from additional coverage up to these levels …
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