Health: Parliamentarians call for a limitation exceedance fee

Posted on June 18th, 2009 in Uncategorized

Arès more than five months of debate, punctuated by petitions, demonstrations and intense lobbying by health professionals, the law “Hôpital, patients, health territory” to complete its parliamentary journey. Deputies and senators, meeting in joint commission (CMP), agreed on Tuesday 16 June on a final text, which should be formally adopted on 23 and 24 June by the National Assembly and the Senate.

Agree, disagree? Comment on the article you just read
Subscribe to Monde.fr: € 6 per month + 30 days available
On the initiative of deputies of the majority, the CMP has adopted an amendment calling for treaty partners (trade unions of doctors and health insurance) to arrive before 15 October, an agreement to limit exceedance fees. “Either the treaty partners result in an acceptable date, the Parliament will resume the hand,” warns Yves Bur (UMP, Bas-Rhin) one of the deputies to the origin of the amendment.

Apart from this key point, members of the CMP have changed the margin that the outcome of the reading in the Senate. In the end, even if it has undergone many adjustments, the reform supported by the Health Minister, Roselyne Bachelot, has kept almost intact its original architecture.

Hospital governance changed. Despite some concessions by the hospital doctors, most of the governance reform hospital is preserved.

In accordance with the wishes of the President of the Republic to give the hospital a “real boss”, the school director sees its power increased. He chairs an Executive Board, whose vice-president is the president of the medical establishment (CME) and appoints the heads of medical centers, which some services.

Removed from the appointment process in the original text, clinicians received the President of the CME has a power of suggestion. In case of disagreement over an appointment, the Hospital Managers have the final word, however.

Mixed results on access to care. Faced with rising inequality in access to health care – with the geographical progression of medical and financial desert with increasing exceedance fees – the government has only partially changed the situation.

To fight against the desert medical, law bet on a range of incentives (scholarships for young doctors, aid for the establishment of nursing homes …) in order to motivate doctors to settle in areas under-equipped.

On the initiative of deputies, the Government has endorsed the implementation of “health solidarity contracts”, from 2012: it is obliged, under penalty of fine, doctors in areas with – time to practice in under-equipped. Nicknamed the “tax Bachelot, this coercive measure was strongly opposed by the Confederation of medical french (CSMF), who found an effective link with the Senators from the majority. Since they refused, the Minister has finally passed with the votes of the opposition.

The government has not shown the same tenacity on exceedances fees. While the members wanted to limit them, especially in private clinics, Ms. Bachelot abandoned to face a threat of strike by young interns.

Even apathy about doctors refusing to patients receiving the universal health coverage (CMU): the Government, as parliamentarians, have finally given up the confrontation with the practice of testing, even though the patient groups, which was l One of the main demands.

The challenge of regionalization of the health system. To fight against the dispersal of power and medical contacts in the same territory, the law creates regional health agencies (ARS). These organs of the State will establish greater coordination between the hospital, the medical city and medical-social sector.

A battle deaf however opposed the National Health Insurance and the State on the expertise of ARS in the management of risk (action campaigns on doctors and insurance). On this point, the CMP has tilted the balance in favor of ARS: they have a genuine right to inspect a prerogative hitherto held by the only insurance.

Measures variable geometry on alcohol. The text prohibits sale of alcohol and tobacco to under 18. It also prohibits the sale of alcohol in service stations between 18 hours and 8 hours (against 22 pm to 6 am today).

Finally, the law allows alcohol advertising on the Internet despite the strong protests from defenders of public health.

Published by