A centre-left party in France has called for medical care reimbursement to be revoked from people who refuse to have the Covid-19 vaccine, but it is unlikely if this would even be allowed in France, or recommended. We explain.
Le Parti radical de gauche (PRG) has said that people who are not vaccinated should no longer “be reimbursed for healthcare associated with their choice, and should pay the healthcare fees of the people that they will infect”.
Guillaume Lacroix, president of PRG-Le centre gauche, said: “Society must carry the cost of the vaccines, but not the cost of those who refuse to protect themselves and to protect others.”
The comments come as the French public appears reluctant to be vaccinated in large numbers; a poll from Ipsos found that just 54% of people would have the vaccination if it becomes available.
This is lower than the percentage needed for effective vaccination coverage - for example, for measles, which is very contagious, a 95% vaccination coverage is needed among the population to stop the illness from spreading, especially among those who cannot be vaccinated (if they are immuno-suppressed, for example).
The PRG is not the only party to propose harsh regulation around the Covid-19 vaccine; in early November, MEP Yannick Jadot, of eco party Europe Écologie-Les Verts (EELV) said that the vaccine should be mandatory.
France unlikely to make vaccination compulsory
Yet, President Emmanuel Macron and Health Minister Olivier Veran have so far said this is unlikely to happen, as has la Haute Autorité de Santé.
In his televised speech on November 24, President Macron said: “I will not make vaccination mandatory.”
An expert at the Agence Regionale de Sante (ARS) has said: “Paradoxically, when a vaccination is not mandatory, those who doubt it find themselves validated; they say that the government is not forcing it on us, because the vaccine isn’t safe.
“When actually, [not making it mandatory] is in contrast, aiming not to feed this defiance.”
Is withdrawing reimbursement a good course of action?
Overall, experts in France suggest not.
Withdrawing reimbursement could be seen as a way to effectively make vaccination “mandatory”, without actually doing so.
Similar policies are already practised in China to regulate behaviour.
As shown in the documentary Coronation by activist Ai Weiwei, one 65-year-old woman says although she has the right to leave her home in theory, because she is aged over 65, if she gets Covid as a result, her medical fees will not be covered.
But in France, medical fees have never been correlated to the behaviour of the patient. Someone who gets lung cancer linked to heavy smoking, or cirrhosis of the liver linked to excess drinking, will still have their medical costs reimbursed regardless of whether they stop smoking or drinking.
One ARS expert explained to Le Figaro: “The only time we ask ourselves the question, is when poorly-prepared skiers go to do off-piste skiing, and then they call a helicopter to come and pick them up. There, the consensus is generally that they should share the cost.”
Legally, the question of withdrawing medical reimbursement would be in the hands of the annual budget review, the projet de loi de financement de la Sécurité Sociale, which is voted for in parliament every year.
But overall, in response to the PRG’s proposal, immunologist and professor emeritus of the Collège de France, Professor Alain Fischer told Le Figaro that in France, communication - rather than the threat of non-payment of medical costs - was a better idea.
He said: “A very large information campaign, with a real effort on communication and education is needed. This should not just come down from the authorities, but also doctors, patient associations of people with chronic illnesses, who can really help the messaging. We must convince people, explain, inform.”
He added: “Vaccination goes in concentric circles, and the first people to be vaccinated will pass that onto others, who will see that it has gone well, which will allow us to convince people in gradual steps.
“There is an altruistic nature in vaccination, which is about protecting other people, and a whole part of the population that is especially sensitive.”
Earlier this month, president of government advisory council le Conseil Scientifique, Professor Delfraissy, said: “We must pay very careful attention before making a Covid-19 vaccination mandatory. It would be preferable for our citizens to take control themselves.
“I would expect that older and more fragile people will get vaccines en masse. For the younger people, getting vaccinated in such a context as this is a civic act.”