Standing up to your doctor shouldn’t go unpunished for much longer. These unfulfilled appointments, the bane of white coats, are in the sights of senators, who have introduced a “rabbit tax” into the Social Security financing bill currently under consideration. Invited on the Sud Radio morning show this Wednesday, the Minister of Public Accounts, Thomas Cazenave, said he was in favor of “a mechanism which makes it possible to sanction” the patients in question. “I find that there is a huge waste and I share this problem raised by the doctors,” he added.
The government currently seems undecided on the nature of the sanction. “I don’t know if it will be a tax,” the minister hastened to qualify. As a reminder, the tax proposed by the senators would consist of charging a lump sum to each insured person who has not kept their appointment with a city health professional. The amount would be fixed by decree and allocated to Health Insurance. The amount could be paid directly by the insured person to their fund, taken from their bank account with their authorization or recovered, by the Health Insurance organization, from future benefits of all kinds.
This is not the first time that parliamentarians have expressed their desire to tighten the screws on ill-behaved patients. At the time of the examination of the Rist law, the senators had voted for an amendment establishing “compensation for the doctor at the expense of the socially insured person” who would not honor his appointment. This provision was not retained in the final text. This time the government seems to want to move forward. In addition to Thomas Cazenave’s declaration, doctors can count on the support of Emmanuel Macron, who affirmed in January in an interview with Le Parisien that it was necessary to “give patients greater responsibility”, and that “those who do not come to appointments you will be punished a little.”
The white coats are waiting for the government at the turning point, while the phenomenon is in full expansion. More than 40% of general practitioners report at least five unfulfilled appointments per week, according to a survey published Monday by our colleagues at “Généraliste”. The National Academy of Medicine and the National Council of the Order of Physicians estimated, at the start of 2023, that the phenomenon affected 6 to 10% of patients with an appointment each week. For its part, the National Health Insurance Fund (Cnam) cites an appointment cancellation rate which could be between 3 and 4%.