EXCLUSIVE – Faced with the anger of doctors, Health Insurance should give up paying practitioners according to the relevance of their sick leaves. The threat of a workers’ strike looms large.
On reading these lines, the blood of the doctors has only changed. In a document presented this morning during a conventional meeting, the Health Insurance has proposed to change the rules of the ROSP, remuneration for public health objectives (prescriptions of generics, medical office equipment, screening for certain cancers, etc. ). A check paid to liberal doctors which amounted to an average of 4,514 euros last year.
One measure in particular did not pass on the side of the medical unions, the introduction into the ROSP of indicators relating to the relevance of work stoppage prescriptions (daily allowances) with regard to existing recommendations. Thus, the doctors are invited by the High Authority of Health (HAS) to prescribe 5 days of sick leave for a seasonal flu, 3 for a sore throat or 21 days for a serious sprain when the patient performs “heavy physical work” .
Four unions ready to quit bargaining
“When a work stoppage is prescribed online (AAT), its duration is more often in accordance with existing standards, probably because of the possibility of choosing among the standard durations offered by the tool”, writes the CNAM in the document. . “ROSP indicators could enhance compliance with the benchmarks contained therein,” she adds. An end of non-receipt for the CSFM (1), the FMF (2), the SML (3), and LE BLOC. These four unions have even threatened to leave the negotiating table if the measure appears in the next medical agreement.
Dr Jean-Paul Ortiz, president of the CSFM: ” It’s a terrifying mechanism if we put it in place. The CNAM could monitor the patient and the doctor for each… “
The idea of penalties abandoned
Another measure that did not pass, the creation of a “penalty for the remuneration of efficiency indicators”. While ROSP has hitherto rewarded virtuous practices, Health Insurance now takes into account the public health objectives not achieved by the practitioners concerned (general practitioners, cardiologists, gastroenterologists). With the direct consequence of a reduction in the amounts paid to doctors. But the same, the medical unions did not want to hear about it.
Dr Jean-Paul Ortiz : ” The proposal concerning penalties is unacceptable. The ROSP must promote good care, it is a quality approach… “
And these have been heard. Contacted by Why actor, Dr Jean-Paul Ortiz, president of the CSMF, indicated that today’s meeting at the headquarters of the Health Insurance took place in a “very tense” climate. But this did not last very long since Nicolas Revel, Director General of the CNAM, committed at the end of the session to abandon the penalties. The incentive to reduce work stoppages is also in the process of being withdrawn. On this point, Health Insurance has indeed promised that it will “listen to the claims of doctors”, concludes Dr. Jean-Paul Ortiz. Answer at the next conventional session scheduled for next Wednesday.
In the meantime, Dr Jean-Paul Hamon, president of the FMF, promises a “strike of zeal” if the measure is maintained. “If the Health Insurance does not backtrack, we will apply the strict standards of the HAS. I guarantee that the daily allowances will increase, ”he threatens. For the CNAM, the bill could be steep …
Jean-Paul Hamon, president of the FMF: ” If Nicolas Revel persists, the strict social security guidelines will be applied. They want war, they will have it… “
(1) Confederation of French Medical Syndicates
(2) Federation of Doctors of France
(3) Union of Liberal Doctors
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