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Doctors who refuse to treat people on the CMU


NormanH
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There are some Doctors in France (and particularly in the Paris area) who are reluctant to take patients on the CMU, according to this article.

Google translation:

Doctors resist the CMU

A large number of doctors refuse to treat patients who receive little off of the universal health coverage. It is a matter of astonishment and even indignation, even if some of the doctors who are listening are likely to disagree. What is it? Universal

health coverage, the CMU, established by Lionel Jospin and Martine

Aubry a few years ago, is just over 4 million people whose incomes are

low.
The Nation has decided to take over almost completely, in solidarity, the cost of their care. There may be abuse, there is no doubt, but it is a reform that does justice to a country.

But on one condition: that all players in the health system play the

game that an investigation has been conducted for the Fund to finance

the CMU by a very serious shows that this is not the case.
The beneficiaries of the CMU are indeed victims of denial of care. Actors drew hundreds of doctors in Paris and called for an appointment. This is called a "testing".

Results,

Collen Vincent, a journalist for "Echoes," reveals that out of 861

responses received, approximately 25% of doctors tested a quarter

refuse patients covered by CMU.
  Admittedly, this survey covers only Paris but the situation in large cities must be the same. Now he must look in detail. There are few offices closed for general whose fees are framed, ie engaged in consultation at 23 euros. But the proportion

of refusals increased to 28% among gynecologists, 33% among generalists

who perform fee-free, 36% among dentists and 38% for ophthalmologists.

How to explain this refusal must be one thing clear: the refusal to receive a patient is not illegal, except in emergencies of course. The only possible sanction is that of the College of Physicians. To return to your question, the main reason is economic. Doctors free fee may not apply overexpenditures fees for people who are in the CMU system. Dentists are also rather poorly paid. All this, they are in less revenue. Some doctors cite the lack of card readers or ill Vitale reimbursements by social security.

These explanations are not convincing. So it is not to preach to doctors.  Some certainly have their reasons to refuse patients. In Paris, it sometimes can be difficult, financially, for a significant proportion of customers who pay little. However, this can be true of all. If the disposable income to live a generalist is 70,000 euros per year, it exceeds 80,000 euros for a gynecologist. It should not be far from 130,000 euros to an ophthalmologist.

This shows in all cases all the ambiguity of a system

that works badly on two legs, where doctors are largely but not wholly

paid by the community while being able to choose their patients.
This freedom is a right but also entails duties.
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This article doe snot make sense as translated by google.  If a person goes to a French GP and shows the Carte Vitale then the GP has no way of knowing whether that Carte Vitale was issued as a result of the person being in employment or through CMU.  I do not believe there can be any mechanism inplace for turning away people who obtain CV through CMU.
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[quote user="Jhc"] I do not believe there can be any mechanism inplace for turning away people who obtain CV through CMU.[/quote]

There are programmes shown periodically on French TV documenting that doctors of all kinds (and others) refusing CMU patients is a fact of life.

I can't quite remember how it goes, but if you look like you might be on CMU (i.e. the destitute look) then if it is a doctor who doesn't want CMU patients, he/she will turn you away immediately.

I also remember when going to the kiné or lab, or clinic, that they might ask you if you have top-up health insurance. If you do, you show proof. If you don't, you might then be asked some more probing questions - you might answer "I don't need it, I have CMU" - then they know.

There are all sorts of ways. In any case, I seem to remember that when your carte vitale is swiped, it clearly indicates whether you are on CMU complémentaire, or just CMU de base. Then all it takes, is not to give you another appointment, even if manage to get the one.

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It certainly is true - as 5 element says once the card is swiped the doctor knows and can refuse to sign the form for a médicin traitant. You must have a médicin traitant for the CMU to function.  This is even more difficult in rural areas where it is hard for people to get to another doctor if the local one won't take them..
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