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Already carried out in 2012 and 2016 by the Consumers’ Union, this third study of the health divide in metropolitan France updates the situation. It determines access to different categories of doctors. The UFC-Que Choisir even offers an interactive map accessible from their website – allowing everyone to realize their own access to care – and calls on the government to reduce this “intolerable health divide”.
A sanitary fracture. These are the words used by the Union des consommateurs to designate “the deplorable state of geographical and financial access to healthcare in France”. If the words may seem harsh, the situation is just as harsh.
Lack of generalists and (especially) specialists
The UFC-Que Choisir study therefore analyzes direct access to four categories of doctors: general practitioners, pediatricians, ophthalmologists and gynecologists. Taking into account the medical offer accessible within a 45-minute drive, the analysis shows that:
- 19% of French people (i.e. 12.3 million people) live in a medical desert for ophthalmology;
- 23.6% of women are also residents of a medical desert with regard to gynecology;
- And 27.5% of children in metropolitan France live in a pediatric medical desert area.
Finally, notes the Union, “While medical deserts are less important for general practitioners (2.6% of the population), the situation is no less worrying since 23.5% of users experience difficulty in accessing less than 30 minutes’ drive from this essential link in the care pathway”.
A significant financial obstacle
To stick as close as possible to reality, the UFC-Que Choisir also took into account the prices charged by doctors. Indeed, as the Union rightly points out “the financial obstacle is the first explanation (29% of cases) of the renunciation of patient care”.
And when we look at access to physicians who do not practice overcharges, the “shortage of doctors grows in a maddening way“.
Thereby, “the proportion of children living in pediatric medical deserts thus rose to 46.8% (+19.3 points), and that of women residing in gynecological medical deserts to 66.8% (+43.2 points). The percentage of the population living in an ophthalmological medical desert goes from simple to more than triple (62.8%, i.e. + 43.8 points)!” the Union is alarmed.
The president of UFC-Que Choisir, Alain Bazot explains that they have “chose these four specialties because they do not depend on the care pathway and they are the ones that concern the most people as welli”.
A free interactive map
Following this lackluster observation, you are surely wondering what your personal situation is, knowing that a medical desert is not necessarily rural (as rightly reminded by UFC-Que Choisir)?
To find out, you can use the map made available free of charge on their site, in order to better understand your situation and “challenge your parliamentarians directly” invites the Union.
According to Alain Bazot, they are the ones who can change the situation. “We have reached a point where there is no longer a balance between the number of doctors and the freedom of installation. It could work when there were a number of them, but today, it is necessary to regulate their installation and their allow to settle only in places in tension. The argument of the numerus clausus no longer holds: it is because there is a shortage of doctors that the installation must be controlled” believes the president of UFC-Que Choisir.
A call to the government
For its part, the UFC-Que Choisir appeals to the public authorities and the government, in particular to “Allowing equal access to care for all users“, even if according to Alain Bazot, “the government remains inflexible for the moment”. For the Union de consommateurs, the following three avenues should be put in place:
- Establish a territorial agreement for doctorsno longer allowing them to settle in over-provided areas, with the exception of sector 1 (social security tariff) when the situation requires it (replacement of a retiring doctor or very largely under-resourced area in doctors in sector 1);
- Close access to sector 2 (at free fees) at the origin of the uncontrolled development of fee overruns. New doctors should only have the choice between a sector 1 with fees without overruns and the Option of controlled tariff practice (OPTAM), which regulates overruns of fees;
- Remove public aid for doctors who do not respect the social security tariffexcluding OPTAM.