After that of the State, it is the turn of the Social Security budget to pass the test by fire. Presented this Tuesday to the National Assembly, the Social Security financing bill (PLFSS) for 2024 has already attracted the wrath of opposition deputies during its examination in committee. The articles setting the spending targets for the different branches of Social Security were deleted in turn, then the text was rejected in its entirety last Friday. A snub for the government which will not, however, prevent the text from being adopted. The executive does not hide its desire to draw up a new 49.3.
Placed under the sign of parsimony, the financing project nevertheless increases the Social Security deficit, reaching 11.2 billion in 2024, or two billion more than in 2023. This is why the government is seeking savings everywhere. In particular one of 3.5 billion euros, by revising downwards the expenses of the health branch. If these reductions may raise eyebrows, other points of the PLFSS are supposed to facilitate access to care for the population. Le Figaro takes stock of these measures which will most affect the daily lives of the French.
Also read Free condoms: what you need to know before it comes into force on January 1
Announced in December 2022 by Emmanuel Macron and implemented from January 1, 2023, free condoms for those under 26 currently only concern two brands. PLFSS 2024 intends to extend it to all brands and models. Article 18 of the text, available on the National Assembly website, must allow “100% coverage by compulsory health insurance and third-party payment of the costs linked to the purchase of condoms for young people under 26 years old. An article supplemented by an amendment tabled by majority deputies so that female condoms are also concerned.
“Menstrual precariousness today concerns 44% of the youngest women (18-24 years old),” explains the government in article 19 of the PLFSS. This is why the text plans to introduce reimbursement for reusable hygienic protection for all women under the age of 26 and beneficiaries of complementary solidarity health insurance.
To deal with “medication shortages”, the government provides, in article 33 of the PLFSS, that “unit delivery (DAU) will be made compulsory for medicines in shortage situations”. In addition, the executive wants to be able to “restrict the prescription of antibiotics by teleconsultation” if necessary. These measures should contribute “to limiting the phenomena of requests for prescriptions of medicines to build up precautionary stocks at home, likely to amplify and maintain these episodes of shortages over a long period”.
Emmanuel Macron announced last February the generalization of a free national vaccination campaign against papillomavirus (HPV) infections for all fifth grade students. However, “vaccination coverage against HPV remains, in fact, insufficient in France while the World Health Organization recommends 90% vaccination coverage,” explains the PLFSS. Article 17 of the executive text therefore provides that “vaccination will be fully covered by health insurance”.
Faced with the increase in fraudulent work stoppages, the government is forced to act. The executive itself recognizes a “very strong dynamic in the expenditure of daily allowances currently observed”. Especially since “the increase in the active population, the aging of the population or even the increase in the amount of the average compensation […] are all important factors to take into account, but which do not allow them to alone to explain the increase in the expenditure of daily allowances. Hence the need to take “collective accountability measures for prescribing professionals and insured persons receiving sick leave”.
This is why articles 27 and 28 of the PLFSS aim to “strengthen the control capacities of primary health insurance funds and employers, and to increase sanctions in the event of undue work stoppage”. In addition to more careful checks by issuing doctors, there is a three-day limitation on the prescription or renewal of sick leave during a teleconsultation.
Article 25 of the Social Security Financing Bill envisages granting authorization to pharmacists to dispense medicines subject to compulsory medical prescription, such as antibiotics, without the need for a prescription. The only condition is to carry out a rapid diagnostic orientation test for cases of simple cystitis and tonsillitis.
“To guarantee better access to care and greater coverage of health costs for as many people as possible”, the government intends to make complementary solidarity health insurance (C2S) more accessible, “by extending it to some of the beneficiaries of four social minimums: the disabled adult allowance (AAH), the supplementary disability allowance (ASI), the specific solidarity allowance (ASS) and the youth employment contract allowance (CEJ),” specifies the Article 21 of the PLFSS. A measure justified by the very high proportion (four times higher than for the entire population”, according to the executive) of beneficiaries of minimum social benefits without additional coverage.
