Lobbying !

[Ron Avery]

[quote user="Suninfrance"]........ although in my opinion it contains an inaccurate passage about people being already refused treatment which I do not believe to be the case.

It is the case Ron.  I know of two people in other regions who have had their treatment refused.
[/quote]

Sun in

If that is the case then the letter is accurate. 

But have these people been refused treatment or has their CPAM refused to pay for it and on what grounds?  As people with E 106s have not been excluded as yet (unless some have expired between 30/09/07 and now) and people already in the CMU have at least until 31/03/08, on what grounds can any doctor, hospital etc have refused treatment?  Have any CPAMs actually withdrawn healthcare rights from people? 

I know some CPAMs acted very quickly originally in siezing a few CVs but all later had to comply at least with the extension to March 2008.

 My sole concern is that if that statement was to be thought inaccurate by the French Minister, as it forms part of what is an otherwise excellent and balanced statement of the case for membership of the CMU for all on the grounds of residency, any inaccuracies could be siezed on and could undermine the overall value of the letter.

[Will]

I don't think anybody would actually be refused treatment, the French system doesn't work like that. If you have no carte vitale, or your card turns out to be invalid or not accepted (or, for that matter, your doctor etc does not have the machine for processing the cards) you merely pay up and apply for a refund from your caisse primaire. Of course, if the refund is then refused, that's a different matter.

Nobody seems to have considered the active population here, even though we are, admittedly, in the minority. The third option could be disastrous for those paying full taxes and cotisations - we could well take up the same stance of, I guess, many of those who have come to France, and speak out firmly against our national health service looking after immigrants.

[Suninfrance]

I doubt very much whether the team at FHI would write something that was not true and not the case.  They are doing a brilliant job on our behalf and are studying the facts before putting them on paper.

As for the grounds of having healthcare refused, some CPAMs are still ahead of themselves until this issue is resolved.

Post edited by RH as it refers to a post which has been removed.

[makfai]

[quote user="cooperlola"]

PERSONALLY (my FHI hat is off now) I think one of 3 things could happen :  1.The minister could issue the statement that she was apparently going to and grant concessions to those in the CMU and install an appeals procedure for E106 holders with chronic and existing illnesses; 2. The bureaucrats could pursuade her to leave the statement as it is - excluding everybody, with the possible exception of legal and legitimate 5 year residents; or 3. The minister could simplify everything and just let everybody here legitimately at 30.9.07 benefit from the state system.  The first is not great but better than the second; the second is unthinkable, especially for those who are ill; the third is the outcome which would be best for all - with the exception of course of those who move here in the future, but at least they have not made a life-changing decision quite yet.

We should all be trying to achieve the third option, whilst taking great care that we do not tip the balance in favour of the second - which is a risk we should not ignore.

[/quote]

Hi Coops - I did not know that the appeals process was only designed to accommodate E106 holders. That is disconcerting! What about other categories such as those who have arrived without E106s or those who arrived with other 'E' Forms and no longer have the entitlement (e.g. E121 holders who lose their Incap Benefit status).  What about those who start with private insurance then lose it because they develop a health problem? I had thought the appeal process on health ground was to be open to all, sorry to hear otherwise.

As regards other matters, I have always fully recognised the fact that the current climate should not be 'ignored' but it is the how that is applied in practice where I think some of us differ. In view of your recommendation - and starting with the text I published which has created concern  - what do you personally suggest we can do in practical terms in order to 'not tip the balance'?

As regards the text I published it contained an 'old' issue and some 'new' ones  The OLD one was 'inequality' but it was suggested that we should not raise that issue. I don't see the value in that argument as the matter has already been raised.

The NEW issues in the text were

• that we should underline the fact that excluding E106 holders would add to the  complexity/workload CNAM/CPAM people as such would only lead to appeals from E106 holders who had nothing to lose by appealing [Note: The time for such appeals is ticking away while the authorities get their act into gear over a matter they knew about well over  4 years ago!]. 

• increases in workload could mean increases in taxation to pay for extra staff and we did not support that as taxpayers

• if the exclusion of E106 holders was successfully appealed at EU level – a likely outcome - then all this extra work done by the CPAM etc staff would have been for nothing BUT would then have to be corrected for every case.  In addition to any increase in workload, this could lead to claims for reimbursement of fees paid to commercial insurers or for compensation for those who felt that they had been compelled to give up residence in France.  This financial burden would have to be met by the taxpayer.

Personally, I do not see how these new issues ignore the delicacy of the situation or how they would tip the balance against residents currently affiliated to the CMU but, as ever, I would be grateful for your advice.

Frankly, I am now concerned that the authorities may sense that they can play one category off against the other and also delay matters so  putting additional pressure on some people who are facing a deadline next month. In the time that is left and with holidays approaching, what will happen if these people want to appeal? Will they be given affiliation to the CMU until the appeal is completed?  There is an argument for such treatment under Article 41 of the CHARTER OF FUNDAMENTAL RIGHTS OF THE EUROPEAN UNION (2000/C 364/01) [see below]  but it is going to take time to get THAT argument accepted and time is not on the side of the E106 holders whose entitlement expires next month.  Delaying lobbying for their cause is, in my view, not an option.

Article 41

Right to good administration

1. Every person has the right to have his or her affairs handled impartially, fairly and within a reasonable time by the institutions and bodies of the Union.

2. This right includes:

. the right of every person to be heard, before any individual measure which would affect him or her adversely is taken;

. the right of every person to have access to his or her file, while respecting the legitimate interests of confidentiality and of professional and business secrecy;

. the obligation of the administration to give reasons for its decisions.

 

 

[Cat]

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[Sunday Driver]

I have to agree with cooperlola's assessment of the delicacy of the current situation.  All of the issues are well understood by the French government and it's now down to a simple political choice.....

1. Maintain the current situation involving total exclusion with all the budgetary and organisational benefits - the best option from the FG's point of view, but clearly politically unsustainable in the face of diplomatic pressure from the UK and EU and that's why they've pulled back from it

2. Revert to the previous situation and allow everyone to stay affilliated for heathcare - a total political climbdown which will send signals to any similar group who cares to challenge the government's decisions.  Remember, we've already had indications of official concerns over a potential influx of immigrants from the newly joined EU member states...

3. Leave the exisitng CMU people with their cover and grant appeal concessions to those non-qualifying E106 holders with pre-existing or future medical conditions - a political compromise which defuses the 'abandoning the critically ill' objections and leaves those who are excluded but healthy with a short term financial contribution which falls in line with the FG's stated 'retire early but don't expect France to pay' line.

I believe the FG are now stuck between a rock and a hard place.  Options 1 and 2 are the most politically damaging to them, so I suspect they'll stick with option 3 and just tell the CPAMs to get on with it.

 

 

 

[walsden]

[quote user="Ron Avery"]

If that is the case then the letter is accurate. 

But have these people been refused treatment or has their CPAM refused to pay for it and on what grounds?  As people with E 106s have not been excluded as yet (unless some have expired between 30/09/07 and now) and people already in the CMU have at least until 31/03/08, on what grounds can any doctor, hospital etc have refused treatment?  Have any CPAMs actually withdrawn healthcare rights from people? 

I know some CPAMs acted very quickly originally in siezing a few CVs but all later had to comply at least with the extension to March 2008.

 My sole concern is that if that statement was to be thought inaccurate by the French Minister, as it forms part of what is an otherwise excellent and balanced statement of the case for membership of the CMU for all on the grounds of residency, any inaccuracies could be siezed on and could undermine the overall value of the letter.

[/quote]

Ron, you may not agree with the letter but please don't belittle the efforts of those who have worked so hard campaigning (on behalf of ALL). Nobody is forcing you to sign the letter. I find your suggestion that it is inaccurate and that the overall value could be undermined is insulting to both those who have written it and those who have signed it.

 

[cooperlola]

Makfai, my apologies, you are correct in that the minister's spokesperson also said that the appeals procedure also made provision for other circumstances.  I will find the quote and post it to make this clearer.

Personally, I don't know the answer to the question as to how one does this without annoying somebody!  It's inevitable that not everybody on all the sides of the house will be in agreement, and no matter what one does, there will be others who feel a different route is better - and I don't see anybody as "wrong" in this - the only people acting unfairly in this are those in authority who have interpreted laws with scant regard for the humanitarian aspects of what they are doing.

I only ask that we vent our justifiable anger and frustration on the real culprits here - and not one another!

[Clair]

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[Tony F Dordogne]

Two deletions on one page - and people are continually feeling that they have to justify their individual positions or points of view in public.

Now let's assume that the FG is monitoring this Forum - and it's likely, as they will be with the Health site - all the detailed arguments in public is just making their job easier.  We need to keep some of our arguments quiet and as far under wraps as we can in case we have to deal the FG some 'knock out' at some stage, not air our increasingly convuluted arguments like this.

And surely, the people on the email list from Copperlola and her team should be discussing this as part of the campaign - if you feel strongly enough to post on here, hopefully you're on the email list also? 

Come on folks, lets just discuss these issues on email, privately (tho that is always monitored of course) and not drag our differences out in public.  A divided opposition, whether the division is real or not, is the start of a defeated opposition.

[Suninfrance]

Agree absolutely, Tony F.

[cooperlola]

[quote user="Ron Avery"]

As far as I know its not the policy of FHI to follow either of us.  FHI have their own views individually and collectively and they have not endorsed your proposed course of action,[/quote]

As said previously, FHI believes that individual approaches are an individual decision, and as far as I am aware we have neither endorsed it, nor have we done the opposite.

The minister's letter is just one part of a many-pronged attack and we are very busy with other approaches too - including looking at Makfai's - but all this takes time and we do have a democratic process to undertake before making decisions either way.

Our website will continue to reflect the group's thinking once decisions are made. What individual members may think in private is their own affair and nothing to do with FHI - we don't all necessarily feel the same way about things, which is why we discuss them carefully before reaching a consensus, based on a majority view.

Meanwhile, to re-iterate what I (PERSONALLY!) said before - Tony is right - let's get angry with those who have caused this problem - not one another.

[makfai]

[quote user="cooperlola"]

Makfai, my apologies, you are correct in that the minister's spokesperson also said that the appeals procedure also made provision for other circumstances.  I will find the quote and post it to make this clearer.

Personally, I don't know the answer to the question as to how one does this without annoying somebody!  It's inevitable that not everybody on all the sides of the house will be in agreement, and no matter what one does, there will be others who feel a different route is better - and I don't see anybody as "wrong" in this - the only people acting unfairly in this are those in authority who have interpreted laws with scant regard for the humanitarian aspects of what they are doing.

I only ask that we vent our justifiable anger and frustration on the real culprits here - and not one another!

[/quote]

Coops.. Glad to hear that!  I thought we had taken a step back there.

On other matters, I was not asking how to avoid 'annoying' anyone (I doubt none of us can avoid that from time to time) but how to avoid what you referred to as tipping the balance at Government level over what I had drafted.

Finally, (put your FHI hat back-on now!) any ideas if the Arcticle from the Charter I referred to will be of any help if things stay as they are and E106 holders are not allowed to affiliate?

[Ron Avery]

[quote user="walsden"]

Ron, you may not agree with the letter but please don't belittle the efforts of those who have worked so hard campaigning (on behalf of ALL). Nobody is forcing you to sign the letter. I find your suggestion that it is inaccurate and that the overall value could be undermined is insulting to both those who have written it and those who have signed it.

[/quote]

I have not anywhere belittled the work of those who are working so hard, where does it say that I have??

Is Will undermining their efforts by stating that he does not believe that treatment has been refused, which has allegedly upset CPAM staff? There is a big difference between refused treatment and a refusal to pay for it.

I repeat, my only concern is that if that statement was believed inaccurate by the French Minister, as it forms part of what is an otherwise excellent and balanced statement of the case for membership of the CMU for all on the grounds of residency, any inaccuracies could be siezed on and could undermine the overall value of the letter. Just what is wrong with that ???

[cooperlola]

Makfai - FHI HAT FIRMLY OFF!!! (Evidently I need to specify).

Personally - I like the arguments and think they are useful.  My tipping the balance comment is there because I wonder (and I really don't know!) if there won't be certain people in CPAM offices who are thinking - "I've done all this paperwork, complied with the new regs and now here's another letter from these people I've got to answer.  I wish they'd all just go away."  If the statement remains unchanged, then the CPAMs have already gone most of the way down that route so it will be easier for them.  So I'm just not sure - and as I say this is just my gut feeling, not anybody else's - that sending more letters to the already beleagured bureaucrats will help.  I think it would be better for everybody to make the excellent points you have raised to the same senior bureaucrat - rather than a smaller number of letters to individual offices some of whom must be getting heartily sick of the whole business by now.  Thus I think one could be making a mistake targetting individual offices.  That is my only reservation.

[Sunday Driver]

Perhaps FHI will take on board these comments and consider whether the mention of these apparently isolated instances of refusal of treatment really adds value to the core argument.

 

 

[cooperlola]

[quote user="Sunday Driver"]

Perhaps FHI will take on board these comments and consider whether the mention of these apparently isolated instances of refusal of treatment really adds value to the core argument.

 

 

[/quote]We have of course been discussing this at length and have removed the past participle from the sentence - although we do know of one or two cases where E106's expired at unusual times - where exclusion has already happened - we agreed that this was preferable, in view of the comments.

FHI HAT OFF NOW:

It is difficult to assess how the practicalites will work and whether anybody will be refused a life saving operation if they are here illegally (without PHI or EHIC). But,  I've certainly had a letter from one person who was living here before the CMU was available to anybody - who remebers sitting in a hospital waiting room awaiting treatment while phone calls were being made to her insurer to confirm that her treatment would be paid for before any medic would intervene.   This could well happen again if this goes ahead so refusal of treatment is a very real possibility.

[Sunday Driver]

The outstanding success of the FHI group has been largely due to having targetted those people who have the most influence and who have been able to make the greatest impact upon our cause - the international political big guns like Mary Honeyball, Jim Murphy, et al.

This has been the most effective lobbying strategy, and is evidenced by the results to date. Let's continue to support them and heed cooperlola's advice.

 

[makfai]

[quote user="Sunday Driver"]

The outstanding success of the FHI group has been largely due to having targetted those people who have the most influence and who have been able to make the greatest impact upon our cause - the international political big guns like Mary Honeyball, Jim Murphy, et al.

This has been the most effective lobbying strategy, and is evidenced by the results to date. Let's continue to support them and heed cooperlola's advice.

 

[/quote]

I second that (indeed, have actively engaged in that) but do not see that one tactic should exclude another.

[Sunday Driver]

Replies getting mixed up here....

Regarding the treatment refusals, any suggestion that they were caused by unusual circumstances/timing gives them opportunity to argue that they were just exceptions, therefore the point will be lost.  If that's a risk, then it may be better to 'lose it' before sending the letter.....

 

[cooperlola]

[quote user="makfai"][quote user="Sunday Driver"]

The outstanding success of the FHI group has been largely due to having targetted those people who have the most influence and who have been able to make the greatest impact upon our cause - the international political big guns like Mary Honeyball, Jim Murphy, et al.

This has been the most effective lobbying strategy, and is evidenced by the results to date. Let's continue to support them and heed cooperlola's advice.

 

[/quote]

I second that (indeed, have actively engaged in that) but do not see that one tactic should exclude another.

[/quote]As I say, it is entirely up to the individual what they do - they have all the choices and now it's up to them - they may even have a better way (if so, let us know please!)  Perhaps it's best to judge the individual approach based on what one already knows about one's own local offices and officers?  Nothing wrong that I can see in everybody doing everything they can to get what they want - so long as they're happy that they've considered it carefully then go ahead - after all, who are any of us to stop them - we can all think for ourselves can't we?

Likewise with our letter to the minister.  If any individual does not like a specific paragraph, then please cut and paste it, remove the bits you don't like, and sign and send  it as an individual.  Easy. A French translation will be available shortly.

[caramac]

[quote user="cooperlola"]

A French translation will be available shortly.

[/quote]

Is that an English or French "shortly"?  [;-)]

[Suninfrance]

Now, now - lol.

[makfai]

I am completely happy to leave my discussions over the text I prepared where they are now.  Let each person make his or her mind up as to what course of action they wish to take.

I would also make it clear that the FHI has and continues to have my full support in its efforts.  They have a thankless task in what is a crisis situation. Equally, I would encourage everyone not to leave this issue to the efforts of just those who make up the FHI.  Make your suggestions to them and the Forums, the FHI needs practical as well as moral support.

[Rob]

The drift of the campaign against this new law is deeply worrying, as those on E106s, and those yet to relocate to France, appear to have been abandoned.

 

See, for instance, the FHI open letter to the French Minister of Health, which effectively concludes by saying that the lifeboats are full of existing CMU affiliates, and that no-one else can be accommodated.

 

What nonsense it is that we should now effectively cease campaigning against this law, for fear that we might lose the concessions that appear to have thus far been granted!

 

The reason why the French Government have delayed publication of the new circular is that they know they are in a legal and political minefield.

 

However, if the Government does anything that hardens this legislation, they are also likely to find themselves in front of tribunals the length and breadth of the country, as well as the European Court. The basic law is discriminatory and fundamentally flawed.

 

It is not FHI who are between a rock and a hard place, but the French Government.

 

Surely at this point we should seeking, not to rein in our aspirations, but to continue to put so many torpedoes into the side of this ship, that she is unable to stay afloat?

 

A strategy of seeking maximum concessions and exemptions to the basic law based on residence, contribution, pre-existing medical conditions, future serious medical condition, temporary employment, divorce and other exception circumstances, needs to be at the root of the campaign.

 

Instead of going off on a tangent, and campaigning for those in the CMU at the end of Sept 07, we should be pressing for immediate release of the circular, because it probably contains so many opportunities in it for expats to gain entry into the French health system that the basic legislation would cease to worth the paper it was written on.  CNAM do not like it precisely because it is unworkable. Great for us!