Meet the expectations of a hospital in crisis and a liberal medicine in tension, while “master” health spending which continued to increase after the Covid-19 years: the 2024 Social Security budget is thus a complicated equation.
After shrinking over the past three years, the deficit in our welfare state is starting to rise again – at a slightly faster pace than expected. It could reach 11.2 billion euros in 2024, according to the Social Security financing bill presented on Wednesday, September 27, to the Council of Ministers, while the latest forecasts, made in mid-April, anticipated an imbalance of 9.6 billion. This deterioration, which would be even more marked for the following years (with a “hole” of 17.1 billion in 2026, or 4 billion more compared to previous projections), is calculated from the results observed in the compulsory pension schemes. base and the old-age solidarity fund. It is mainly explained by the increased financing needs of Health Insurance – linked in particular to the recent increase in the remuneration of staff employed in health and medico-social establishments.
The government has set aside, at this stage, a measure that has become controversial before even being made official: the scenario of a doubling of medical deductibles – these amounts remaining the responsibility of patients when they purchase a box of medicine (0 .50 euro) or go to the doctor (1 euro) – does not appear in this bill.
“Sickness tax”
This economic avenue had however been put forward in June by Bercy, before being defended in public accounts then in health, and up to Matignon, as a means of “empower” the French in the use of medications and ” to guarantee “ financing the healthcare system. Just a few days ago, those around the Minister of Health, Aurélien Rousseau, estimated the revenue likely to be generated through this approach to be 800 million euros. But in a context of inflation, the measure promised to be explosive: patient associations and doctors’ unions have already stepped up to denounce a “sickness tax”.
The measurement does not necessarily need to be “engraved in stone” of the legislative text, nevertheless argues a parliamentary source in the ranks of the majority: it could go through the regulatory route. Which Bercy confirms.
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