The solutions adopted by the Health Insurance and complementary health insurance to generalize third-party payment have not convinced young doctors.
Health Insurance and complementary health insurance (mutuals, insurers and provident institutions) presented a report on Wednesday detailing their technical solutions for implementing the generalized third-party payment as of November 2017.
The objective of this document: “To provide practical answers” to doctors, indicated Nicolas Revel, director of the National Health Insurance Fund (Cnam).
According to him, the technical device developed will be “simple and reliable”. Representative liberal doctors’ unions (MG France, FMF, CSMF) have used the term “gas factory”.
And for the government, which sometimes plays the generational divide between doctors, failed, young practitioners are also unhappy with the device.
A cost to be borne by the doctor
The first to have taken a position is the ReAGJIR union (Autonomous Regrouping of Generalists Young Installed Replacements). In a statement, these young doctors write that the technical solutions found are “perfectible”, and that “general practitioners refuse to pay out of pocket”.
They are particularly worried about updates and / or external services that have a cost and that “Mr. Revel has excluded from taking charge, postponing this point to future conventional negotiations”, scheduled to begin on February 24.
These doctors are all the more disappointed as they have been mobilized on this subject since June 2014 and continue to request the establishment of a third-party payment system. ReAGJIR therefore hopes to be heard on this subject by the time the final report is submitted to the Minister of Health before the end of the month.
The point of view is, on the other hand, more pessimistic on the part of the National Union of Young General Practitioners (SNJMG) who now considers that Health Insurance and complementary health insurance are “unable to offer an efficient third-party payment!” “
They complain in particular that this project maintains “the initial registration by the doctor of the patient’s AMC (complementary health insurance) affiliation rights, of the two financial flows leaving the doctor’s computer and two financial flows returning”.
Broken promises
Worse still, he denounces the commitments not kept by the Minister of Health before Parliament in March 2015. Marisol Touraine had indeed promised that “doctors will only have to make a single gesture to trigger payment. The extension of third-party payment necessarily includes a technical solution common to health insurance and complementary health insurance (…) This system will make it possible to send doctors a single payment flow, the government has committed simple, the law answers it “.
But despite these calls for civil disobedience, the schedule is maintained by the government. As of December 31, 2016, the third-party payment will become a right for all patients covered 100% by Social Security. And in November 2017, they will be for all patients for the part reimbursed by the compulsory Health Insurance.
Finally, on the same date, complementary health insurance must obligatorily offer third-party payment within the framework of responsible contracts, that is to say more than 90% of the market..
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