The last round of tariff negotiations between the medical unions and the Health Insurance opens on Tuesday on the future medical convention of liberal practitioners.
A slight increase in overall budget (+86 million euros), complex consultations revalued to 48 euros (against 46 euros currently) and a coordination increase increased to 5 euros, this is what the Health Insurance has offered to liberal doctors unions last week. A few days before the end of conventional negotiations, “the CNAM (1) seems to be evolving”, writes the CSMF (2).
Suddenly, the first liberal doctors’ unions indicated on Monday that they will participate in the last round of tariff discussions. It begins this Tuesday 19 and will continue on 20 and 21 July. And this comeback is done in order to convince. Dr Jean-Paul Ortiz, president of the organization, considers that “many hard and unavoidable points persist”.
“The CSMF will participate in this final stretch to try to obtain perhaps essential advances in order to allow a possible signature,” he adds. However, he recalls that this decision will be up to the Extraordinary General Assembly of the organization which will be held on Saturday 23 July.
The calendar of the C to 25 rejected
And like the CSMF, the other unions (MG France, SML, FMF, LE BLOC) should be present at the tables. The points of tension will undoubtedly revolve around the basic consultation of the general practitioner revalued to 25 euros. Previously set at 23 euros, this is the CNAM calendar (1 euro on the 1er April 2017 and 1 euro in 2018) which concentrates the critics.
In addition, Nicolas Revel, director general of the CNAM, will also be expected by the doctors on the amount of the “structure package”, intended to finance the equipment and organization of practices. The FMF believed that it should not be less than € 50,000 per year, “Even if the structure package could be variable depending on the place of installation and the mode of exercise isolated or grouped”, she specified.
But the amount is likely to be well below the wishes of the trade unionists. To justify itself, the CNAM keeps repeating that the consultation of general practitioners at 25 euros will already cost it 445 million euros. “Nicolas Revel will make new gestures, but he warned that it will be necessary to respect the framework of theNational Health Insurance Expenditure Objective (ONDAM), which implies a staggering of the measures over at least two years ”, report in this regard The echoes.
Deadline August 26
Faced with such a badly embarked negotiation, we must remember the rules. Author of the book “From trade unionism to convention, the history of a long river not so quiet”, Dr Patrick Carlioz explained that “at least three signatures will be needed for a new medical convention to come into force” . “If this is not the case, it is a minimum arbitration rule which will emerge”, he specified.
The arbitrator who is none other than the president of the High Council for the family, Bertrand Fragonard, will fix by decree the new relations between the health insurance and the liberal doctors so that the patients continue to be reimbursed. The worst option for all the unions at the table.
As a reminder, the medical unions and the Health Insurance have until August 26 to agree on a text.
(1) National Health Insurance Fund
(2) Confederation of French Medical Syndicates
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