The installation aid, amounting to up to 50,000 euros, was granted to 2,085 doctors, mainly general practitioners. But this does not compensate for inequalities in access to care.
Inequalities in access to general practitioners have increased in recent years, despite the aid paid to encourage practitioners to settle in medical deserts, according to a report established in early July by Health Insurance and consulted Monday by AFP .
The “carrot policy” did not bear fruit. Negotiated in 2016 with the unions of liberal doctors, four types of “demographic contractswere supposed to stem the spread of medical deserts. But at the end of 2021, only 4,685 were “In progress“, according to the report presented on July 8 in an internal commission of the Health insurance.
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Less than five thousand in five years, of which a large half (2,396) of contract “coordination» for practitioners already in place. The installation aid itself (up to 50,000 euros) was granted to 2,085 doctors, mainly general practitioners, or just over 400 per year. All of these devices are showing an increasing cost: more than 94 million euros over the period 2017-2020, of which nearly 32 million in 2020 alone.
Stick policy
A cost compared to a “efficiency“not obvious, since”unequal access“to general practitioners”has increased“between the end of 2016 and the end of 2019, according to Health Insurance, which notes on the contrary a”reducing disparitiesfor self-employed nurses and midwives.
Two professions which, unlike doctors, are benefiting from constantly increasing numbers but have also accepted a “regulation“installations: an arrival for a departure in the areas”over-endowed“.
This contrast gives arguments to the partisans of the policy of the stick. Thus Unsa judges in a press release that the “extremely disappointing result” incentives demonstrate that they “do not work» and that he «we must therefore put an end to the freedom of installation of liberal doctors“.
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The Health Insurance recognizes for its part, in a report published at the beginning of July, that its “demographic contracts“don’t have”not enough to erase the imbalances in territorial distribution that persist» and proposes to «merge into a single contractto simplify the device. The subject will soon return to the table of the “big conferenceon access to care promised by Emmanuel Macron, especially since the executive will have to define its roadmap before the negotiation of a new medical convention from the fall.
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