Goal of the new school year: to save money. As ministers return to the Elysee Palace this week, the 2024 budget is emerging as the main challenge for this fall. And raising it will not be an easy task. The state wants to reduce its debt, which has exceeded 3,000 billion euros. But several projects, such as the military programming law or the increase in the index point for civil servants, will need funding. Added to this, the executive’s promise not to raise taxes. Result: the 2024 budget is increasingly acting as a headache.
To solve the equation, the government is studying all possible avenues for savings. The Public Finance Conference took place in June, followed by recommendations from the Court of Auditors and a “review of public expenditure”. Some measures have emerged, such as the end of the Pinel system, the reduction in the price of training paid by the State for apprentices, or the gradual disappearance of reduced tariffs on energy for players in the construction industry, agriculture and haulage. But one sector is particularly targeted: health. The executive intends to reduce its expenditure there.
Medicines and consultations less well reimbursed
Main avenue under study: medical franchises. This is a part that is not reimbursed and remains payable by the patient when he incurs a health expense. It is generally 50 cents on medicines, and one euro for consultations with the general practitioner. The government plans to double these deductibles. They could reach one euro for medicines and two euros for consultations. The State thus hopes to achieve between 500 million and one billion euros in savings.
At the moment, nothing is settled. But the Minister of Health, Aurélien Rousseau, acknowledged that this measure was indeed “on the table”, evoking Monday on BMFTV the need for a “collective accountability effort”. The amount of medical deductibles has hardly changed since their introduction in 2008. On the other hand, if the consumption of drugs has been falling in France since the 2000s, it is still very high compared to its European neighbors, according to the National Agency for the Safety of Medicines (ANSM).
More controlled sick leave
Another measure envisaged: the strengthening of the control of sick leaves. The government has denounced “abusive” and too costly appeals. The number of sick leaves has indeed increased by 30% over the last ten years, according to the Ministry of the Economy. 8.8 million were prescribed in 2022, with a cost of around 14 billion euros. The liberal doctors were thus asked not to “over-prescribe” stops.
For its part, Social Security has already announced that it will lower reimbursements for dental care from October 2023. Welcome savings for the government, at a time when the economic environment is toughening. The growth forecast is “only” 1% in 2023 according to the State, a figure higher than those of INSEE (0.6%) and the Banque de France (0.7%). In addition, European fiscal rules are expected to be reinstated next year, after years of suspension due to Covid-19. Bercy has also promised Brussels to return to below the 3% deficit mark in 2027. It currently represents 4.7% of GDP, according to figures for 2022 communicated by INSEE.