Health: this alternative to the “Grande Security” project that pester mutuals

Big Bang in sight?The High Council for the Future of Health Insurance (HCAAM) must present, during the month of November, avenues for improving the relationship between health insurance and complementary health.Plane above this report, the idea of creating a "great security", as the echoes reveal.Concretely for the insured, it would be a question of having a single reimbursement organization for the same treatment.If the concrete realization of such a project will surely invite itself in the debates of the presidential election, for Frédéric Bizard, economist, creator of the Health Institute and author of the book “Solidarity autonomy in health”, Health and complementary health insurancecan continue to coexist, provided that they clearly define their role.

Capital: Should the care methods be fully reviewed?

Frédéric Bizard: The current financing system is very ineffective and very unequal.Our financing system has derived because health insurance is the only financier to ensure the real risk.By that I mean the risk which can generate an impoverishment of people in relation to health costs.Thus, as soon as you have a long -term condition that can generate significant care, you are reimbursed 100 % by social security.As soon as you have a very large surgical operation which can result in tens of thousands of euros, the security reimburses you at more than 90 %.Same thing for very expensive drugs.It is this weight of long -term conditions which represents almost two thirds of expenses for health insurance.These expenses are growing strongly, especially due to the aging of the population.

Capital: On the other hand, it is the complementary who reimburses more common care such as optics or dental ...

Frédéric Bizard: There was a disengagement of health insurance for current care.This has been done by raising dental care, the current care for general practitioners or nursing has little for 40 years,.So private insurers have replaced, with the downstream of the public authorities, for the management of this current care.However, the development of collective contracts, with the care of half of the premium by the employer, benefits employees who generally do not need very important protection.So, that in parallel, those who must be well protected like the unemployed or retirees do not benefit from this care.It costs them very expensive and they are badly protected.

Capital: To avoid this situation would the solution be to create a "great security", as a scenario of HCAAM advocates?

Frédéric Bizard: The debate on this “great security” is taking a direction which guarantees that nothing will happen.We say: "We are going to be radical, we will remove the mutuals and we will increase public spending by 23 billion".All this is not very serious in a context where public accounts are derailed.On the other hand, this is a very serious subject, which is simple to solve.

Capital: How?

Frédéric Bizard: at the Health Institute, we have been working for three years at the overhaul of the health system.To make this system effective, it must be said who finances what and have only one health benefit financier.In the system to which we reflect, the complementary would no longer complete public funding but would only be funding from certain services, where they are already in the majority.This is the example of optics, dental prostheses, hearing aids or even health transport.

Capital: The cost of this reorganization could be very important for Social Security?

Frédéric Bizard: Not necessarily because you are already saving colossal management by limiting back and forth between security and mutual.Management costs of health insurance and complementary is 15 billion euros.It is also necessary to readjust the amount of moderator (amount that social security leaves the insured, editor's note), make it well paid, and keep the existing exemptions for the most modest households, pregnant women orstill people with a long -term condition.You therefore have a moderator ticket which represents a small sum, but as there are hundreds of millions of consultations, these small sums make billions.Let us also add that with the system we offer, the SAP will save billions of euros by no longer funding certain care such as dental prostheses (which would be the responsibility of mutuals, editor's note).

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Capital: What would be the gains of this overhaul for the insured?

Frédéric Bizard: The first gain is better readability.Today if you go to the dentist you are unable to know who pays what.This will no longer be the case.Then the system would be more equitable.For this, it would also be necessary to regulate the private insurance market with a standard contract which is a system of the system.This allows the market to be transparent and organize it according to the real insurance model.You come back to an individual affiliation, and no longer collective business, to really pool all risks.You make private funding in solidarity which makes it possible to considerably lower the premium.Thus those who are the major consumers of this care as retirees will be able to pay less while being better protected.It is an individual shared subscription over the entire population.