The conventional negotiations between liberal doctors and the Health Insurance are becoming more complicated. A fifth session, potentially one of the last ones, was scheduled for Thursday, April 4th, but an external decision disrupted this round aimed at reaching an agreement on the key issue of the new consultation fees, at a time when medical deserts are increasing. The main specialist syndicate Avenir-Spé Le Bloc, along with the UFML-S (French Union for Free Medicine), decided to suspend their participation in the discussions due to their disagreement with the new hospital fees announced on March 26th. While the other syndicates did not follow suit on Thursday morning, the National Health Insurance Fund (CNAM) announced the cancellation of the session and its postponement to a later date, possibly April 18th.
The disagreement stemmed from the announcement made a few days earlier by the Ministry of Health of an increase in hospital fees by 4.3% in the public and non-profit sector, but only by 0.3% in the for-profit private sector. This differential treatment caused an uproar, leading the private hospital federation, representing 1,030 establishments with 40,000 liberal doctors, to call for a total strike starting on June 3rd. This differential tariff has been viewed as an attack on liberal doctors, especially specialists, by President of Avenir-Spé Le Bloc Patrick Gasser. He expressed concern about the impact of this tariff difference on small-size establishments already facing challenges, warning that many might disappear. He also highlighted significant difficulties in the conventional negotiations, calling on the government to review its approach.
Jerome Marty from the UFML-S also voiced concerns about the government’s decision to jeopardize the negotiations with the new tariff, which he believes will threaten the existence of hundreds of establishments. These actions have raised doubts about the possibility of continuing discussions in such circumstances. After a first setback in the winter of 2023, these negotiations, reopened by the government almost six months ago, were entering their final stage. The proposal to increase the basic consultation fee to 30 euros from the current 26.50 euros was on the table in previous sessions, along with collective “counterparts” requested from doctors regarding access to care or the relevance of medical acts. Other topics included strengthening the “treating physician” flat fee or increasing fees for long consultations for patients over 80 years old.
The tensions between public and private sectors have escalated due to the differential treatment in the new tariff decision, with private hospitals feeling particularly targeted. The threat of hundreds of establishments facing closure due to the tariff difference has sparked a strong reaction from various syndicates and unions representing liberal doctors. The cancellation of the negotiations session and the postponement date have further complicated the situation, raising questions about the future of the talks and the potential outcomes. The government’s role in the negotiations and its decisions regarding hospital fees are under scrutiny, with calls for a reevaluation of the approach to ensure the sustainability of liberal medical practices and small healthcare establishments.
