At the heart of our lives for two years due to the Covid pandemic, health issues can be of particular importance when reading the programs. Especially since the projects in this area are proving to be immense: medical deserts, rescuing a hospital system out of breath, place of city medicine in the system, capacity for innovation, place of health research…
The “presidential program” in the form of a summary of Emmanuel Macron for the next five years is succinct. The president, however, puts forward a substantial assessment of non-Covid measures such as “100% health” for hearing aids, glasses and dental care or free contraception. On the side of Marine Le Pen, the program “M France” is more stocky: 13 pages are devoted to health around three main themes: the public hospital, outpatient medicine and the fight against fraud. Another source of interest, on a more scientific side, is the questionnaire sent to candidates before the first round by the Academy of Sciences, which includes a section on the theme of health. Only eight candidates had responded – including Emmanuel Macron – but not Marine Le Pen.
Health according to Marine Le Pen:
The program of the candidate of the National Rally envisages a vast reorganization of the administrative framework of the hospital, but also of the accessibility to care. Two major health issues stand out: medical deserts and the organization of public hospitals. Here are some of his proposals on these first two parts.
- Abolition of regional health agencies, the ARS, “to lift the administrative yoke”. The measure aims to reaffirm the authority of the State in the field of health, and would return the supervision of hospitals to the regional prefects via the regional directorates of health and social affairs. With a view to further lightening the administrative burden, hospitals would have shared governance between the hospital director and a doctor for medical matters.
- 10% administrative positions in hospitals, maximum. A ceiling which must provide room for maneuver to recruit more nursing staff.
- Massive recruitment of nursing staff to fill vacant positions. Opening of 10,000 additional places in nursing care training institutes (IFSI) and nursing assistant training centres.
- While France has seen the number of hospital beds fall by 25% in 20 years (486,000 beds in 2000 against 386,000 in 2020), the candidate wishes to establish a moratorium on the removal of beds at the public hospital.
- Significantly reinforce the personnel of the emergency services and organize a partnership between emergencies and liberal cabinets towards which could be redirected the patients coming under the city medicine and not the emergencies. Create a separate channel for older people to better guide them.
- Reduce the number of medical deserts through financial incentives : payment for the consultation modulated according to the place of installation, without the practitioners having to take any specific steps.
- A massive investment plan in telemedicine in all its forms: teleconsultation, telecare, tele-expertise, medical telemonitoring.
- Increase the “medical time” of the practitioner thanks to the extension of the tasks entrusted to pharmacists, midwives and nurses.
The third part of the health theme is dedicated to the fight against fraud. In addition to securing the issuance and use of new tamper-proof biometric Vitale cards, the candidate proposes to transform State Medical Aid (AME) to reserve it only for urgent care. For the record, the AME is a social aid mainly intended to cover the medical expenses of foreigners in an irregular situation.
Health according to Emmanuel Macron:
Some balance sheet measures:
- The abolition of the numerus clausus, which limited the number of medical graduates, to eventually solve the shortage of doctors.
- The “100% health” for the reimbursement of hearing aids, glasses and dental care without charge.
- The doubling of nursing homes (2018 to December 31, 2022 against 1034 in 2017, according to the government).
- Free oral contraception for women up to 25 years old and free distribution of sanitary napkins to female students.
- The MonPsy device which offers reimbursement by Health Insurance for eight sessions with a psychologist.
- A “sexual health” consultation fully supported from 15 to 25 years old.
- PrEP, a treatment for preventing the transmission of HIV, can now be prescribed by all doctors.
As for the proposals present in the “presidential programme”, some are orientations more than proposals strictly speaking. They revolve around three themes:
- “Giving priority to prevention” through the development of remote monitoring for people suffering from a chronic illness (such as diabetes, for example), or the implementation of “detection and prevention plans relating to mental health, infertility, sickle cell disease…” The possibility also to open a complete and free health check “at key ages (25, 45 and 60)”. Finally, the president-candidate promises “an ambitious policy for women’s health”.
- “Continue the rescue of the hospital”. In addition to “a recruitment plan for nurses and nursing assistants”, Emmanuel Macron wishes to lighten the administrative burden for caregivers, give doctors a central place in governance and strengthen the role of paramedics.
- “Inwards”. The candidate promises to relocate the production of drugs to France and to continue the development of 20 biomedicines and biotechnologies (in particular against cancers), as well as new technologies such as exoskeletons.
Finally, his answers to questions from the Academy of Sciences allow three subjects to be addressed. is about animal testing, it proposes to reduce its necessary share by financing the search for alternatives. Regarding the supervision of genome editing techniques, Emmanuel Macron refers to the bioethics law voted in 2021, which lays down certain prohibitions: the creation of chimeric human embryos by adding animal stem cells, the creation of embryos for research purposes, the cloning and reimplantation of embryos intended for reimplantation. On public healtha discipline in which France is less efficient than certain neighbors (the United Kingdom in particular), Macron proposes to integrate “specific training in public health in all health studies. We will create a French and European sector of environmental medicine which will allow us to better predict and treat infectious diseases such as zoonoses.”
It should be noted that, according to our colleagues from echoesthe president-candidate would still plan new announcements in terms of health, such as the maintenance of generalized wages in the event of sick leave, full third-party payment via Health Insurance or even 100% reimbursement of orthodontics.
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