The time has come to open a real debate on compensation for sick leave, without caricature or excess, not to question their legitimacy or their existence, not to question the imperative of solidarity of this system which will soon celebrate a century of existence and even less to carry out what some already describe as a step backwards. We must open this debate because compensation must be fair between those who contribute and those who benefit. In this sense, the avenues formulated by the government by acting on waiting days and the level of compensation offer a useful and timely avenue for discussion.
In any case, it is a much more relevant avenue for restoring our social accounts than what was proposed during the examination of the social security budget. The double burden that we are putting on our companies by the elimination of reductions in contributions but also by the reduction in support for apprenticeships accompanied by numerous cuts in healthcare and hospitals is not acceptable. Worse, these avenues could make inadmissible the desire to make the French responsible for preserving our solidarity system while penalizing employment.
This debate responds a priori to a triple need: to face the changes which are shaking up the world of work, to correct the effects of the numerous political errors, first and foremost the chaotic application of the 35-hour week and finally, to preserve social accounts and therefore our model of solidarity. We do not work enough, not well enough, not in good conditions by spending ever more to support a social system which opens a new security hole.
France holds the top spot among its neighbors in terms of absenteeism rates
We know that France is at the top of the table among its neighbors in terms of absenteeism rates. In 2022, sick leave represented billions of euros in expenditure for Social Security, not to mention the indirect cost for businesses and the slowdown in public services.
According to the Court of Auditors, the direct cost for social security of days not worked amounts to 12.8 billion euros for the entire public service. Regarding the private sector, the expenses borne by companies for compensation for work stoppages reached 11.6 billion euros in 2022. Although absenteeism cannot be completely eliminated, reducing the average number of days of absence to bring it closer to that observed in the private sector could save almost 2 billion euros. Furthermore, we, French people in all sectors, benefit on average from 4.3 weeks of leave per year and 2.1 weeks of sick leave, compared to 1.6 weeks of leave and 1.2 weeks of sick leave in Germany. . Let us also recall the specific situation of self-employed people who take on average only 3 days off per year while contributing like everyone else to the social system!
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We must therefore re-evaluate the sharing of the burden, review the system to identify what constitutes abuse, penalizes the entire population and what is necessary because absenteeism has a significant economic impact. In 2022, it represented an average annual cost of 4,000 euros per employee in the private sector. For hospitals, the impact is particularly heavy, and as a hospital worker, I was able to see the impact of the 35-hour week but also of the prolonged absences of caregivers who often have to be compensated by overtime, temporary recruitment, temporary work. , which generates additional costs and disrupts the organization of healthcare services. The causes are obviously multifactorial and in this regard we must also question our training policy for doctors and paramedics, access to care, and the statutory and financial valuation of our health professionals.
Another lever of accountability which promotes real sharing of the burden to preserve our social system and fight against absenteeism, which I wish to support, is the establishment of a so-called “public order” waiting day. In short, work stoppages during this day, would no longer be compensated by the CNAM, nor by employers, nor by supplementary workers. There should be no taboos.
The French must indeed be able to regain full confidence in their social system
More generally, the debate on sick leave will also make it possible to question an inequality that, in my opinion, is unjustified between private and public employees by aligning the number of waiting days in the two sectors. This inequality is accompanied by a difference in the level of absenteeism which is approximately 14.5 days per year per agent in the public service compared to 11.7 days per employee in the private sector. The effectiveness of this lever is proven: the reintroduction of the waiting day in the civil service in 2018 achieved its objective of reducing short-term leave, thus allowing budgetary savings of 134 million euros for the State in 2023 More generally, this waiting day helped reduce the absenteeism rate by 23% according to INSEE.
This framework for compensation for sick leave will inevitably have to be part of a renewal of the social contract which will be based, I believe, on trust. The French must indeed be able to regain full confidence in their social system, and be able to count on better care at all ages of life. Without this confidence that the State must instill in its policies, they will not be able to consent to these frameworks at the risk of perceiving an excess of accountability on the part of a State incapable of providing them with a guarantee worthy of the name. Failure to find this balance is to inflict a double punishment on the French: that of a system which no longer guarantees solidarity accompanied by a policy which resembles a permanent sanction. This reform must also be considered from the angle of adaptation by pathologies.
The sole imperative of safeguarding our social system must guide us when we open these debates
Finally, this measure acting on the deficiency must be accompanied by a more general reflection on working conditions, the division between professional and personal life. New relationship at work, parental leave, teleworking, are all questions that will have to be put on the table.
These objectives must be able to bring together a large majority, in line with the expectations of the French (67% of French people in favor, for example, of extending the waiting period). For my part, I am convinced of this as general rapporteur of social security accounts but also as a doctor.
The sole imperative of safeguarding our social system, inherited from the National Council of Resistance, must guide us when we open these debates.
