“Financing the provision of health services” : The expression may seem technical, but today it refers to one of the biggest concerns in the health world: seeing new private players investing in the care sector, at the risk of market abuse.
To shed light on the current movement, a fact-finding mission from the Senate’s Social Affairs Committee, headed by a trio of parliamentarians – Bernard Jomier (Place Publique, Paris), Corinne Imbert (Les Républicains, Charente-Maritime) and Olivier Henno (Union of Democrats and Independents of the North) – has just published, on Wednesday 25 September, a report which offers a first substantial inventory on the subject. The title, although formulated in an interrogative manner, sets the tone: “A public takeover bid for health care?”.
In certain sectors, the “lever” The French market is already widely compromised, say the authors of this 256-page report: this is the case for for-profit clinics, where four large groups concentrate almost half of the French market (Ramsay Santé, Elsan, Vivalto and Almaviva). The same is true for biology laboratories, identified as “most financialized sector” In the field of urban healthcare, around a few large groups (six of them currently represent two thirds of the centres). A sector in full swing “arm wrestling” With Health Insurance: Many medical biology laboratories went on strike from September 20 to 23 to protest the application of lower prices.
“Black box” for public authorities
In other sectors, this movement began more recently but is accelerating: this is the case of medical imaging, which is experiencing a very active dynamic and which is said to be “financialized” at 20 to 30% of the sector. But also health centres, mainly dental and ophthalmological, pharmacies or even primary care centres (which group general practitioners), in which the interest of investors (Ramsay Santé, Ipso) has recently been growing.
The speakers put their magnifying glass on this transformation of a “the so-called professional capitalism”in which doctors, pharmacists, biologists, etc. retain control of the means of production of consultations and clinics, towards a “financialized capitalism”where external investors take financial and strategic control of companies.
And then? If the report mentions an investment “profitable” AND ” sure “ For private groups, with valuations that can reach, for example in the image sector, between thirteen and fifteen times the gross operating surplus, he mentions, with regard to the remuneration of these actors, a “black box” for public authorities. And it broadly questions the ability of the supervisory authorities, the regional health agencies (ARS) and Medicare, to control this process, “compliance with the criteria of accessibility, quality and relevance of care”.
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