France’s 2024 budget plans for healthcare: What could change for you?

More prescription charges, pill-by-pill dispensing, and new rules on transport reimbursements are all proposed

A doctor filling out a patient form while using a laptop computer
France is aiming to address its social security deficit
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The first draft of France’s social security budget bill for 2024 has been published, with new changes proposed for healthcare next year. We look at what it could mean for you.

The 2024 projet de loi de financement de la Sécurité sociale (PLFSS), published in late September, marks the government’s aim to tackle France’s social security deficit. This is estimated at €8.8 billion for 2023, and €11.2 billion for 2024.

In 2024, the government is aiming to save €3.5 billion in spending by France’s state health insurance system.

‘Increased responsibility’

A saving of €1.2 billion is set to come from increasing “responsibility” among patients and healthcare professionals, in a bid to reduce unnecessary or excess prescriptions.

For example, the franchise médicale - the out-of-pocket fee paid by patients for prescriptions and some treatment sessions - is likely to increase.

Read more: What is France’s ‘franchise médicale’ fee and why might it go up soon?

Rising number of sick notes

The government is also set to tackle the rising number of sick notes - arrêts maladie - by increasing the state’s and employers’ powers to double check the notes’ legitimacy.

For example, employers will be able to assign an approved doctor to evaluate the employee. If the doctor feels that the patient has been signed off work unnecessarily, the employer will then be able to suspend daily illness payments. The employee will be able to appeal the decision.

The government has also said it is planning to work on a reform of daily illness payments in the next few months.

The PLFSS also intends to limit the number of days that a single sick note can keep someone off work when prescribed via a teleconsultation. The limit will be three days. Some exceptions may apply to this; for example when the sick note is written by a patient’s usual GP.

Read more: Doctors under fire over number of sick days they grant French workers

Drug shortages

The PLFSS aims to address worsening drug shortages by requiring pharmacies to sell some tablets ‘pill by pill’ rather than in a pack.

This could happen when a certain drug is considered to be in short supply, such as the antibiotic Clamoxyl.

The aim is to prescribe the exact amount each patient will need.

Read more: Some antibiotics may be sold pill by pill due to shortages in France

The PLFSS also states that some patients will need to take a test rapide d’orientation diagnostique before certain antibiotics are dispensed. This aims to ensure that antibiotics are only given out when it is medically necessary - for example, only if a throat infection is caused by bacteria rather than a virus.

This could cut medicine shortages and reduce the risk of antibiotic resistance.

Shared transport

The PLFSS also includes a section on patients who do not wish to share medical transport services with another patient.

This refers to free (covered by the Assurance maladie) transport services offered to help patients get to a hospital or doctor’s appointment.

If a patient refuses to share with another patient without a valid medical reason, they will have to pay the cost. Patients will only be reimbursed on the cost of a shared transport trip.

Period poverty

The PLFSS also states that reusable period products - such as period pants and menstrual cups - will be reimbursed for women aged 25 and under who are receiving the complémentaire santé solidaire (CSS).

The CSS gives free or low-cost medical insurance top-ups to people on a low income.

Free condoms

The PLFSS is also set to make condoms free from pharmacies, for people aged 25 and under.

Read more: France makes condoms free for people aged 18-25

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