Posted Apr 13, 2023, 7:14 PMUpdated on Apr 13, 2023 at 7:19 PM
Discussions between Bercy and the Ministry of Health are getting tougher as the government must detail next week the trajectory of public finances for the next few years in the stability program intended for the European Commission.
According to our information, the Ministry of Health is afraid of running out of resources in 2024. The ministry would like the executive to expect an increase in health insurance expenditure of at least 3% next year. However, Bercy would rely on a less dynamic progression of the national objective of health insurance expenditure (Ondam).
The decision has not yet been made. “With the high inflation of 2022 and 2023, the demands of professionals are accumulating in all sectors and it will be impossible to cope with them with an Ondam increase of less than 3% next year”, argues a government source.
Hospitals hit by inflation
For the record, health insurance expenditure (those linked to Covid apart) was to increase by 2.7% in 2024 and the following year, according to the latest Social Security budget. The pension reform, still awaiting the verdict of the Constitutional Council, has however already revised this target to 2.8% for 2024.
An Ondam below 3% would be all the more difficult to maintain as inflation remains very dynamic. Bercy and the Banque de France expect a decline in price increases from this summer. But the stability program will record an average inflation forecast for 2023 revised upwards, to nearly 5% according to our information, against 4.2% previously anticipated. The French Observatory of Economic Conditions (OFCE) even anticipates inflation of 5.8% this year.
At the same time, health expenditure is expected to evolve much more slowly at… 3.8% this year. Claiming to be hit hard by the evolution of prices, public and private hospitals are already demanding an increase in their resources.
Targeted measures
The dynamism of inflation will push civil servants to demand a further increase in the index point, on the strength of the decision to that effect last summer. Inflation pushing up wages also tends to inflate the cost of daily allowances paid by the Health Insurance to people on sick leave.
In addition, the Ministry of Health is under pressure to take action on numerous targeted measures. Hospital workers want to be better paid for their on-call and night work and the government has promised to move forward on this “difficult work site”.
Vaccination
To this could be added other expenses, such as those related to vaccination against the papillomavirus, which the President of the Republic has promised to generalize from next September. Liberal professionals are also fighting to obtain better remuneration. The negotiations conducted by the Health Insurance with general practitioners and specialists on this subject have failed. However, they should resume after an arbitrator appointed to find a way out on this subject has returned his copy. And other negotiations will start like those conducted with dentists.
Whatever the arbitration of Matignon on Ondam 2024 appearing in the stability program, it is therefore very likely that the figure will be revised upwards anyway, by the presentation of the 2024 Security budget. social in September. The government will then have better visibility on the slippage in spending for the current year and those to come next year.
