The problem is only growing bigger from year to year. Chronic diseases (cardiovascular diseases, diabetes, cancers, psychiatric illnesses, etc.) continue their very clear progression in France, with a significant impact on public finances.
According to a report from Health Insurance obtained by L’Express, in 2022, 24 million people were consuming care related to at least one chronic illness. That is 1,560,000 more French people than in 2015.
Some chronic diseases are progressing faster than others. This is the case for cardiovascular diseases, with more than 160,000 additional patients treated in the last two years. But also for diabetes, which has affected 320,000 additional people.
Psychiatric illnesses and psychotropic treatments, with more than 8,500,000 French people affected, or more than one in 10 French people, also appear to be at the heart of these recurring problems.
This dynamic is partly explained by the aging of the French population: the oldest people are the most affected by chronic diseases. Other factors must be taken into account, such as the eating habits of the French, as well as their propensity to practice physical activities. Finally, the improvement in recent years in the consideration of these phenomena may also have contributed to these figures.
112 billion euros of expenditure
This increase in cases is not without consequences for the Health Insurance budget. While its deficit is still expected to be more than 11 billion euros for the year 2024, the public body should have no choice but to look for savings in the coming years.
Chronic diseases will inevitably be in the eye of Health Insurance. Thus, in 2022, of the 190.3 billion euros of total Health Insurance expenditure, 59% were devoted to their management. That is a total of 112 billion euros.
Cardiovascular diseases, mental health (including psychiatric pathologies) and cancers alone account for 41% of all expenditure. Diabetes care, which is increasing sharply, also exceeded 10 billion euros in 2022.
Prevention is better than cure?
Still according to this report from Health Insurance, avenues of reflection and proposals are put forward for the next Social Security financing law, in order to rethink and consolidate the French health system. The watchword: better prevention of risks and more screening, rather than having to cure at much higher costs.
Thus, Health Insurance recommends in particular to systematize the regular screening of other diseases for patients already suffering from a chronic cardiovascular disease. But also to better prevent, evaluate and treat chronic pain, by fighting against addiction to opioids.
Or to increase participation in the three organized cancer screenings (colorectal, breast and uterine), for example by deploying “mammobuses” in medical deserts to facilitate access to breast cancer screening.
Another issue: the question of the mental health of adolescents and young adults, among whom the consumption of anxiolytics and antibiotics is increasing sharply. Here too, there is an urgent need to better support the screening and identification of mental disorders in the youngest, but also to better prescribe psychotropic drugs.
The challenge: to prevent these diseases from taking hold, because once they develop, treatment is often very long for patients. The projects are immense. And it is not certain that the current political instability will help to tackle them.