It will have taken a month and a half after the failure of the negotiations of the medical convention to know the contours of the arbitration rules. This agreement, reduced to a minimum, with Health Insurance, which will govern, on a provisional basis, the conditions of exercise and remuneration of liberal doctors, was to be presented to their unions on Monday April 24, before being validated by the Minister of Health within three weeks.
The procedure appears technical; the stakes are high for some 113,000 practitioners, whose spokespersons rejected a first draft convention at the end of February. Firstly, because the revaluation that was offered to them – 26.50 euros for the “basic” consultation, against 25 euros today – seemed to them very insufficient. Secondly, because the logic of a “territorial commitment contract”, conditioning higher levels of remuneration on additional missions, seemed to them unacceptable. It was, however, one of the levers in the fight against the medical deserts defended by the government.
On this point, arbitrator Annick Morel, retired general inspector of social affairs, ruled: “The arbitration rules do not include any revaluation subject to a territorial commitment”can we read in the summary document that The world consulted. “Withholding him would have been a denial of democracy”believes M.me Morel, who spoke with all the parties (unions, young doctors, patient associations, Medicare) before returning her copy.
“My goal is to restart negotiations as soon as possible for a future medical convention”, she defends. This is the argument she also puts forward to justify a level of remuneration which will not fail to disappoint: a general revaluation of 1.50 euros in the price – bringing, therefore, from 25 to 26.50 euros per consultation with a general practitioner, from 30 to 31.50 euros with specialists… Or, precisely, the sums that set fire to the powder this winter.
These new prices, far from expectations (at least 30 euros for a general practitioner, defended the most representative unions), should apply within six months. “I stopped at this balance so that the doctors had an interest in coming back to conclude an agreement, and that the negotiator [l’Assurance-maladie] has room for manoeuvre.she hopes.
“A clear message”
In detail, the arbitration rules renew most of the previous agreement dating back to 2016, with some new features. The “initial registration consultation” as an attending physician for people with long-term illness will be valued at 60 euros. The subject is set up as a political priority, at a time when 714,000 chronically ill people have no attending physician. In the same logic, the “treating doctor patient package” is also increased.
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