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Government Plans €2.5 Billion in Health Care Savings in Pension Reforms

As part of its pension reforms to reduce the Social Security deficit to just over €23 billion in 2011, the French government announced a plan to achieve €2.4 billion in health care savings. These savings would help reduce the health sector deficit and attain French President Nicolas Sarkozy's 2.9 percent target rate for medical inflation in 2011, a growth rate slower than both health care spending (4.4% last year) and growth in the GDP in previous years.

Proposed cost-control measures cut across the health sector. Measures affecting patients include increased cost-sharing for some prescription drugs and medical devices, increased copayments for doctor visits (from 30% to 30.5%), and a higher ceiling on out-of-pocket expenditures for some hospital costs. The measures will not affect out-of-pocket spending for the 87 percent to 90 percent of the French population with complementary private insurance, who will remain fully covered through this supplemental coverage. (In France, supplemental private health insurance reimburses statutory cost-sharing for services also covered by the public health insurance scheme.)

Three measures will affect chronically ill patients, who have previously been exempt from all cost-sharing: transportation will no longer be routinely reimbursed in full, but will be subject to disease-specific guidelines; new patients with mild hypertension will no longer be supported in full (existing hypertensive patients will remain unaffected); and diabetics will only be reimbursed for one blood glucose self-testing strip per day. Again, patients with complementary private health insurance will be covered for the remaining cost through their supplementary coverage. The complementary private health insurance companies (mutuelles) to whom the financial burden will be shifted resisted the reforms.

Other measures include a reduction of hospital management expenses to be achieved through efficiency savings and changes in pricing. General practitioners, however, will receive a one euro increase (from €22 to €23) in their consultation fee. In addition, the income ceiling for low-income people to receive state subsidies to purchase complementary health insurance will be raised, meaning that a greater number of low-income persons will be able to benefit from the subsidies. The unpopular pension reforms, which were met with nationwide strikes, were approved by the French National Assembly in September and the French Senate in October.


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