New plans to beat health deficit

[Clair]

According to this article in today's Figaro, the top man at the CNAMTS (French National Health Insurance Fund for Salaried Workers) has put together a proposal to reduce the enormous deficit.

(google translation)

The proposal suggests that those suffering from ALDs or serious illnesses like cancer, who are currently covered at 100% for health costs related to their illness, should contribute up to 65% of the costs.

In effect, this would align the reimbursement rate with that of other medications.

The proposal suggest the shortfall could be taken up by the mutuelles and also mentions that this new regime should only be applied to new requests for 100% cover.

[cooperlola]

I have just had somebody on the phone to me about this.  A lady in the Dordogne who went to get her Cancer meds (to keep her alive) was told by the pharmacy that she had to pay 65%.  Her CPAM has paid up the difference, but it seems that there is already some confusion, and some think this is already the case!

However, it is -as Clair says - a PROPOSAL only at this stage so don't let anybody try to tell you otherwise.

[cooperlola]

What strikes me about this is that it looks like a political manoevre - hit the ill and the dying as hard as you can initially, then back down and come back with something much softer in the future, which the public will think is a triumph compared with the original proposal.

[Clair]

The report in French (pdf file)

[Cat]

So it's yet another case of the a*** not knowing what the elbow is doing.  How can the regional CPAM offices continue to get it so wrong so badly?  I would have liked to have thought that after the "inactive" Brit farce they might have reviewed their practices so that they all followed the same rules/guidelines, rather than playing at Chinese whispers.

Still, I suppose it gives all of those fonctionaires something to do to make themselves look as if they are keeping busy [:@]

That's France.

[Sunday Driver]

If you're referring to Cooperlola's lady, I think it was the pharmacy that got it wrong and the CPAM stepped in to correct the situation....[Www]

 

 

[Helen]

'L'assurance-maladie propose donc de ne plus rembourser qu'au taux normal de 35% les médicaments à vignette bleue actuellement pris en charge à 100% dans le cadre de l'ALD.'

 

I don't think this is nearly as worrying as it first appears. It seems (if I read it correctly) to apply only to those medicines which are vignette bleu.

There are:

medicaments irremmédicaments irremplaçables et coûteux (vignette blanche et barrée) : 100 % ;
- médicaments dont le service médical rendu a été considéré comme majeur ou important (vignette blanche) : 65 % ;
- médicaments destinés au traitement des affections sans caractère habituel de gravité ou dont le service médical rendu n'a pas été considéré comme majeur ou important (vignette bleue) :  35 %

I assume that most drugs taken by people on ALDs would be in the former 2 categories. 

(edit, I think 'ordinary' pain killers like ibuprofen are vignette bleu. There is  a possibility that might lead to people with chronic pain being prescribed stonger, more expensive but reimbursed drugs)

[cooperlola]

[quote user="Sunday Driver"]

If you're referring to Cooperlola's lady, I think it was the pharmacy that got it wrong and the CPAM stepped in to correct the situation....[Www]

 

 

[/quote]That is correct, S/D.  I perhaps worded it a little obtusely.

Helen : This is what I read the article to say also.  However, I have yet to go through the whole document (rather than just the Figaro piece) as it is 86 pages long....

[Clair]

All the changes concerning ALD and reduced refunds have now been withdrawn from the proposal.

[cooperlola]

Clair, do you have a source for your info' which I could look at? 

[Clair]

Just heard it on the lunchtime France 2 news.

See here: http://www.liberation.fr/actualite/societe/335305.FR.php

Google translation of above.

and here: http://news.google.com/news?ned=fr&hl=fr&ned=fr&q=ald&btnG=Recherche+Actualit%C3%A9s

[cooperlola]

Thank you.[:)]