Wednesday, November 4, 2009

We have seen a number of comparisons of the US and French health care systems.  One knock on the French from those who don't see much value abroad is that their system is in debt.  Indeed, the social security system in France (Secu) is running a deficit. For 2010, the health related deficit will rise to 15 billion euros, up from 10 billion this year.  These deficits have been appearing more often in the recent past and the government feels pressure to address them.

The response comes in the form of "le projet de loi de financement de la Sécurité Sociale" (PLFSS) which attempts to close the gap in revenues and costs by implementing a number of changes in health related prices and payments.  The finance minister called these changes a "modest" reduction in the deficit and it is not expected that they will wipe out all of the gap.

"We were not far from balancing the social security books and now, with the economic (crisis) ... the deficit is taking off again," said Eric Woerth, Minister of Finance on October 1.

"We need to make savings of around 2.2 billion euros to prevent the trend for higher spending from becoming too strong."

These include increasing charges and co-pays.  The hospital co-pay, created in 1983, is to rise from 16 to 18 euros per day.  This is expected to raise 160 million euros.

There will also be a reduction on the reimbursement proportion for pharmaceuticals which are determine dot have "weak" benefits for patients.  That determination is made by the "Haute Autorité de Sante" (HAS).  The savings are estimated at 150 million euros.

There will be a savings as some drugs move into the "generic" category estimated at  200 million euros.

A reduction in the fees paid to radiologists and laboratory practitioners for certain services—saving 240 million.

These will be combined with other controls on the volume of prescriptions by "high rate" practitioners and a reduction in the use of ambulances to transport non-urgent patients.

There are other mechanisms being used to raise taxes, but they are not directly related to the health care system nor are they assigned to reduce the health part of the Secu budget.

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