The Senate pulled out the stretcher. Less than ten days before the examination of the Social Security financing bill (PLFSS) for the year 2025, a trio of parliamentarians – Corinne Imbert (“Les Républicains”), Bernard Jomier (Socialiste, Ecologist and Republican) and Olivier Henno (Centrist Union) presented a report on the control of investment funds over health establishments. “Financialization of healthcare provision: a takeover bid for health? » is the title of this report commissioned by the Senate Social Affairs Committee.
Made public this Wednesday, September 25, the document is critical of the arrival of private financial players in the health field. “Recently entering the public debate, the financialization of healthcare provision remains poorly understood and insufficiently regulated by health authorities”indicate the authors of the fact-finding mission.
A risk of a “speculative bubble”
Born in the 1990s, the practice experienced rapid growth in the 2000s, when investment funds bought shares in several health sectors: private hospital sector or even medical analysis laboratories.
Thus, private hospitalization is today 40% owned by four groups (Ramsay Santé, Elsan, Vivalto, Almaviva), and, for its part, private medical biology is made up of six groups of medical analysis laboratories concentrating, in 2021, 62% of sites.
The phenomenon then spread to the radiology sector, then to dental and ophthalmological health centers, before being introduced “recently” in the “primary care centers”. “Gradually, part of the healthcare offering is shifting from a model of professional capitalism to that of financial capitalism”judges Senator Corinne Imbert.
To the point that, in France, between 2014 and 2023, care has become the third sector targeted by private equity players with 18% of the amounts invested for a cumulative total amount of around 30 billion euros, according to the report. . For these organizations, this branch indeed represents a “profitable investment” due to reimbursement of benefits by the State.
“In the field of medical biology, the profitability rate reached 23% in 2021 and the valuation of the groups on the market has led the National Health Insurance Fund to mention a risk of a “speculative bubble””, note the rapporteurs. A financial windfall that is difficult to quantify for the Cnam and which thus passes under its nose.
Cascading negative repercussions
Barbara Filhol, administrative agent in nursing homes and member of the CGT Federation of Health and Social Action, has seen the repercussions: “This was the case in psychiatric units in Occitanie, where private subcontracting has taken hold. In a public establishment, a private company was mandated to take charge of the radiology department due to a lack of professionals”she explains.
But, in this specific case, “the private company was remunerated by actions instead of the public structure”. And the problems don’t stop there. Financialization also poses problems of concentration of establishments or even worker independence. “The Cnam highlighted before us the biased positioning of the biologist unions, subject to pressure from financial groups during the last conventional negotiations”confides Corinne Imbert.
Thus, parliamentarians point to health effects “poorly evaluated”, “little controlled” and formulate a set of 18 tracks to regulate the practice. In particular, there is a better “regulation” of the phenomenon by relying on activity authorizations issued by regional health agencies (ARS) to ensure a better territorial balance of supply.
Following the model of dental and ophthalmological centers, the rapporteurs also propose making any opening of primary care centers conditional on “an approval”or even stricter supervision of financial players by preventing purely speculative investments.
“It seems essential to us to review the tools for regulating health spending to adapt them to financialization, concludes Bernard Jomier (Socialist, Ecologist and Republican). With these proposals, we wish to define a clear framework for all stakeholders so that public health objectives take precedence. »
Humanity is under attack, defend it!
Your newspaper has been the subject of 5 SLAPP procedures over the past year. Obviously, the truth is disturbing. The forces of money and reactionaries seek to silence us. They won’t make it. Thanks to you!
I want to know more!
