Beware of those who pose rabbits. While negotiations between liberal doctors and Health Insurance opened this Wednesday, November 15, senators are examining this week the Social Security Finance bill (PLFSS) inside which has slipped a new tax.
Adopted by the Social Affairs Committee of the upper house, the amendment tabled by Senator LR Corinne Imbert plans to introduce a financial penalty for any patient who fails to honor their appointment with the doctor. A fixed penalty, the amount of which would be fixed by decree, for the benefit of Social Security.
“Part of this sum, defined within the framework of conventional negotiations, could be paid by Health Insurance to the healthcare professionals concerned as compensation,” specifies the amendment in its letter.
28 million appointments lost each year
The objective? Empower people by hitting the wallet directly at a time when 6% to 10% of patients do not show up for their consultation. Nearly two thirds of these defections concern a first meeting. A “constantly increasing” lack of good citizenship which causes the loss of 28 million consultations each year, deplores the National Council of the Order of Physicians (CNOM).
Guest on the BFMTV set, the president of the council of the order of doctors of Paris, Jean-Jacques Avrane, confirms the false leap epidemic. “We regularly receive a lot of calls from doctors complaining about this problem.” And to pinpoint the results of the study carried out by URPS Ile-de-France which estimates the loss caused by these unfulfilled appointments at two consultation days per month.
An amplifier of medical deserts and the shortage of doctors
An observation that is all the more alarmist given that the questions of “doctor shortage” and “medical deserts” have never been so significant. According to figures from theAtlas of Medical Demography of the National Council of the Order of Physicians (CNOM), France lost, between 2010 and 2022, 10,128 doctors.
Thanks to the rule of supply and demand, refusing a consultation only amplifies the consequences of the shortage of doctors and “primarily penalizes the patients themselves who already have difficulty finding appointments -you”, laments Jean-Jacques Avrane.
Faced with this observation, Emmanuel Macron seemed to send signals favorable to patient empowerment. “Too much medical time is wasted by excessive lack of foresight and casualness, in particular with appointments not kept,” he declared during his wishes to the world of health last January. Before going any further, on April 23 in an interview given to Parisianclaiming to be in favor of “those who do not come to meetings” being “sanctioned a little”.
Platforms, big culprits?
For the CNOM, the embolism appeared with the multiplication and generalization of the use of online appointment booking platforms, accused of having demonetized the relationship between the patient and the doctor. “They should take steps to avoid this problem, for example by making it impossible to make a new appointment in the days following a first appointment,” suggests Jean-Jacques Avrane on BFMTV which welcomes the Senate initiative.
Furthermore, in a press release published last January, the CNOM highlighted the “frequency of appointments made twice with several practitioners depending on the patient’s convenience”, and deplored a phenomenon of “disregard for the medical act considered as a consumer good.”
If the executive is not closed to the introduction of a penalty, the Minister of Health Aurélien Rousseau nevertheless raises some difficulties in the implementation of this “rabbit” tax. According to him, such a system would require “everyone” to make an appointment on the platform. “Which is not the case,” he defends himself.