what you need to know about the increase in the remaining liability from March 31, 2024
Published Saturday February 17 at Official newspaper, the decree hoped to go unnoticed. The medical deductible – the amount deducted from reimbursements made by your mutual insurance company and therefore payable by you – will double from March 31, 2024. For boxes of medicine and paramedical procedures, the deductible will increase from 50 cents to 1 euro. Concerning medical transport, it increases by 2 euros, or 4 euros in total. However, some categories of insured persons are exempt from this excess: minors, pregnant women and people in precarious circumstances benefiting from complementary solidarity health insurance or state medical aid.
This measure comes in a context of deterioration of Social Security accounts. In a note revealed on January 16, the High Council for the Financing of Social Protection sounded the alarm, forecasting an annual deficit on the rise with 17.7 billion euros in 2027 compared to 8.7 billion euros in 2023. With this new increase, the State says it wants to “make the French responsible” for their consumption of medicines which amounted, on average, to 445 euros per inhabitant in 2020 according to a study published by the Spallian firm in 2022. Medicine, care, medications, they don’t cost anything,” Emmanuel Macron declared at the time.
For Brigitte Dormont, professor of economics at Paris-Dauphine University, this measure is primarily intended to be budgetary, “in order to bring in revenue estimated at 800 million euros”. The economist points out this announcement effect which can prove “disastrous in terms of public health”. “The most deprived people tend to consult too late, which is not without consequences. » She continues: “By suggesting that we must make the French responsible by increasing deductibles, the government risks accentuating this too low use of care. » Fifty cents less reimbursed: this amount may seem insignificant, especially since the President of the Republic has decided to maintain the ceiling at 50 euros per year and per person. However, it risks having a heavy impact on low wages. “Those who pass the threshold of 1,093 euros per month cannot claim complementary solidarity to pay for their health expenses,” explains Catherine Simonin, spokesperson for France Assos Santé. They must therefore pay this new increase: 50 euros per year, it becomes enormous. »
The oldest first targeted
Before the increase in the medical deductible, the French had to bear the increase in mutual insurance prices. “Contributions are exploding because there is little competition in this market. To avoid going bankrupt, supplementary companies are obliged to price based on age. Older people therefore see the price of their supplement increase,” analyzes Brigitte Dormont. “Since François Hollande, successive governments have chosen to transfer part of the reimbursement to mutual societies in order not to overburden public spending,” explains economist Nathalie Coutinet. In doing so, the additional cost always falls on the patients. » Last October, in addition, dental costs began to be reimbursed less.
Although aging is a factor to be taken into account, it “plays a marginal role” according to the lecturer at Paris 13 University. “The increase in life expectancy automatically causes an increase in the population. However, we know that we consume more medications at the end of our lives. And whether you're 70 or 80 doesn't change anything. It is always during the last ten years of one's life that one will buy the most. » For this economist, medical technical progress also partly explains the increases observed in recent years. “More and more sophisticated care exists. Take the example of cataracts. Today, a majority of people access this operation. These increases are also a sign of a developed society; advances in medicine that we decided to reimburse,” she concludes.
