A “no”, without nuances. This is what the unions of general practitioners answered to François Braun. The Minister of Health proposed increasing the basic medical consultation from 25 to 26.50 euros. After a long social movement by doctors to demand a revaluation of their work, they even went on strike several times. The case deserves to be noted, because it reveals the whole crisis of the French health system.
There is all the demotivation of the medical profession, and even beyond that, of the medical staff, faced with indigent consultation rates. 25 euros, the basic rate, has not changed since 2017. It is a price that dissuades the strongest vocations.
A price which, as noted by a union official, is lower than that of a beautician session! Indeed, an armpit hair removal session is 40 to 60 euros. Without despising beauticians – it’s a noble profession – let’s say that their expertise and responsibility are less than that of a doctor.
Social Security: indirect employer of doctors
Price is the value we place on things andt salary is an important motivator, for everyone, no matter what. General medicine is a socially useful profession, it is difficult, it requires long studies. All the same, there are good reasons for a doctor to earn a good living.
What blocks is the administration of Social Security … for an understandable reason. It is she who pays, in the form of reimbursements sent to patients. It is thus the indirect employer of doctors. However, its resources are not extensible, it is the social security contributions paid by everyone.
To maintain a good reimbursement rate for the insured, social security is obliged to limit the rates. As tariffs are restricted, doctors no longer want to work. There are currently six million French people without a doctor, many of these patients have chronic diseases.
What is free ends up being expensive
Could we not train more doctors? Even if there are more formally numerus clausus, here again, the administration blocks by limiting the number of doctors trained each year. Always for the same reason: more doctors, it would be more expenses, therefore more reimbursements, therefore more deficit.
It’s exactly the same policy for drugs, of which prices are also limited to save moneywhich deters labs from producing, and causes regrettable shortages.
The only way to constrain health spending in an almost free system that does not control consumption is through rationing. For years now, we have deliberately organized the rationing of health care in France. And it’s probably not over. There is, in fact, no will of the authorities to put an end to it. In other words, limiting the supply of care is the price of free care provided by the community. In general, what is free ends up costing as much as what is paid.
