the flammable trail of “long-term” conditions

What if the doubling of medical deductibles, these unreimbursed amounts on medicines, which are about to increase on March 31 to 1 euro per box, was only the first episode of savings to be made in the health sector? The government has clearly made this clear in recent weeks, by brandishing a new avenue, at least as controversial: questioning the cost of “long-term” illnesses (ALD), a system which, according to the Ministry of Health, benefits thirteen million patients, whose care is therefore 100% covered by Health Insurance.

The time has come to tighten the budgetary screws. The Minister of the Economy, Bruno Le Maire, while defending the need to make, in addition to the 10 billion euros in savings announced for 2024, cuts of 12 billion euros on the 2025 budget, asked the question bluntly in our columns on March 6: “How can we avoid drift in expenses linked to long-term conditions, while continuing to protect patients? » The choice of words did not fail to be denounced in the ranks of patient associations, just like the project, which concerns the reimbursement of care for the sickest among the insured. Even though Bercy has not specified anything about the modalities envisaged.

A trial balloon? The modus operandi reminds observers of the health world of the one borrowed, in 2023, to bring into the debate the project of a reduction in reimbursements on the purchase of prescribed medicines, or even during consultation with the doctor – the famous franchises. Today, as at the time, at the Ministry of Health, we maintain vagueness on what we qualify as a hypothesis, without however ruling it out. This is the pas de deux that Frédéric Valletoux lends himself to, one month after his appointment as delegate minister, when, he recalls, the project has been launched ” Before [son] arrival “within the framework of “expense reviews” initiated by Bercy.

Aging of the population

“Questioning the relevance and usefulness of the system does not shock me”, he explains to us, assuring that“it is, obviously, out of the question to support less well” these patients. More elderly people, more long-term illnesses, soaring expenses… The new minister does not fail to highlight that ALD concerns 20% of policyholders while representing two-thirds of reimbursements. “Going after unnecessary spending is a real issue, every euro spent must be for the benefit of the health of the French people”he said.

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