While the Social Security financing bill (PLFSS) 2025 continues its examination – it came up for discussion in the Senate on Monday, November 18 – the government has just clarified its intentions regarding one of the most sensitive savings measures: the increase of the “moderate commissions”. ”. One of the ways mentioned so far was to modify this amount, which remains the responsibility of the patient, but covered by complementary medical insurance (in most contracts), increasing it by 10 points. While Health Insurance today reimburses 70% of a medical consultation, when mutual insurance companies cover the remaining 30%, there was talk of a new ratio of 60%-40%. All of this, with the aim of generating 1,100 million euros of savings, as part of this transfer from compulsory medical insurance to complementary sickness insurance, in a context of significant Social Security deficit.
At the opening of the debates in session, at the Luxembourg Palace, on Monday, the Minister of Health, Geneviève Darrieussecq, moved the lines: the user ticket “it will only change 5%” for medical consultations, but “besides [celui] on medicines will increase by 5% »said. The other change announced concerns the amount of expected savings, “reduced from 1.1 billion to 900 million euros”the minister specified.
In this way, the coverage of consultations by Health Insurance would increase to 65%. For medicines, the existing reimbursement rates (65%, 30% and 15%, depending on the “medical service provided”) would be reduced a priori in the same proportion. These future developments do not appear as such in the Social Security budget project: they fall into the regulatory level (ministerial decrees). The expected deadline is 2025, without further details at the moment.
“Flatter hit”
For example, today, for a medication reimbursed at 65%, such as an antibiotic (with prescription) at 7.95 euros, the patient is still responsible, in addition to the deductible (1 euro), for a co-payment of 2.78 euros (35%), fully or partially reimbursed by the complementary insurance, depending on the Health Insurance.
The issue may seem technical, but it has already provoked a reaction from patient associations and doctors’ unions, opposed to this increase. In the mutual societies we were also moved by what is considered a “airplane hit” of a magnitude “unpublished”will likely lead to increases in policyholder contributions. A year after the controversy over the doubling, effective as of March, of the “medical deductibles”, that is, the amounts that the patient must pay when purchasing a box of medications (from 0.50 euros to 1 euro) or consult a doctor (from 1 euro to 2 euros) – the future evolution of the user ticket also fueled a fairly unanimous political opposition in the ranks of parliamentarians who examined the PLFSS in the National Assembly in October.
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