The franchise médicale, the obligatory fee which is not reimbursed on the purchase of prescription drugs and certain paramedical services in France, is to increase from 50 cents to €1 from January 2024.
People who are covered by the French social security system will therefore be reimbursed less when purchasing prescription drugs under the change.
The deductible fee is paid out of pocket and not reimbursed by a patient’s private insurances or mutuelles if they have one.
The increased rate will also apply to paramedical services such as nurses, physiotherapists, speech therapists and podiatrists. The deductible for transport costs will also increase from €2 to €4.
However, the annual limit of €50 for prescription medicine and paramedical deductibles will remain in place. This means that the cumulative cost of this can not be more than €50 per patient each year.
Under the tiers payant, or third party payment system, the franchise médicale is rarely paid directly but rather deducted from social security reimbursements.
The plans will also affect people who do not have French social security or have a GHIC or EHIC card. Non-prescription drugs are not concerned by the measure.
‘Safeguarding our model’
The change will help save the social security system €600million, the government says.
“We want to make sure that the social security system is being paid for,” said Minister for Public Accounts Thomas Cazenave announcing the planned change on August 25.
“Since 2017, we have been increasing people’s access to medicine, glasses, hearing aids and dental care… We need to continue financing a healthcare system that is accessible, but at the same time act responsibly, sometimes finding new ways to safeguard our model.”
However, Luc Duquesnel, president of the French medical union confederation, is sceptical.
“This increase goes against the principles and the vision of the social security system,” he told FranceInfo. “It represents a stab in the back of the social contract that is the social security system”.
‘A drop in the ocean’
France’s social security system has been running a high deficit since the Covid-19 pandemic struck in 2020. Over the course of that year, the deficit increased from €1.7billion in 2019 to €38billion in 2020, when the government introduced extensive support for millions of workers while contending with lower revenues.
While the deficit for 2023 is expected to be €8billion, the government is keen to ensure it returns to pre-pandemic levels.
However, healthcare economist Nathalie Coutinet told Capital that saving €600m is not particularly significant.
“It seems like a lot at first glance, but compared to the social security budget of €470billion spent on medical services each year, it’s a drop in the ocean,” she said.