The deficit of public hospitals is exploding and the executive must act on the causes, believes a committee of experts responsible for monitoring the finances of Social Security, which also fears a slippage in health spending in 2024, in view of savings planned but difficult to achieve.
The alert committee on changes in health insurance expenditure is responsible for warning parliamentarians and the government each year in the event of a discrepancy between actual expenditure and the objective voted in the Social Security financing law. . In the forecast budget for 2024, the public authorities allocated 254.7 billion euros to health insurance spending, an increase of 3.2% (excluding Covid-19).
But this amount – lower than what it would be if we took into account the “natural” increase in spending, estimated at 4.6% – implies that 3.5 billion euros in savings will be made, recalls the alert committee in a notice published Monday April evening.
Among the planned measures are the doubling of medical deductibles (remaining responsibility of social security holders) on medicines or paramedical procedures, which came into force in April, and that of fixed contributions to doctors, planned for June. The late schedule limits the scope of the savings, which will only be “partially achieved”, warns the committee.
Implement corrective measures
The experts also underline the “uncertainties” which hover over “the timetable or the amount” of other planned measures, in particular “the expected efficiency savings” at the public hospital (600 million euros). “The spontaneous dynamics of city healthcare expenditure and establishment charges” also creates “a risk” of slippage, they judge.
The deficit in public hospitals is “widening” and constitutes a “major concern”, they warn. Not yet definitively decided, it could “almost double” compared to 2022, when it reached 1 billion euros, “despite the increase in allocations”. “The total deficit will not be definitively known until the summer, which constitutes a clearly excessive delay,” criticizes the committee. He points the finger in particular at late grant payments, the last extension having been granted “well after” the end of the calendar year.
The members of the committee note the “recurrent overestimation of the level of activity” of public establishments: over the first nine months of 2023, the economic volume of activity remains “lower by 2.6%” than in 2019, before the pandemic, while it “exceeds it by 3.1%” in the private sector, they note. The experts call on the public authorities for “a precise analysis of the reasons” for this “recurring under-activity”. Finally, he calls for corrective measures to be implemented, “which cannot be mainly financial support”.