Few options and not popular for government withdrawal of Medicare from long-term illnesses

The potential disengagement of Health Insurance from long-term conditions

\n\nIn France, the care of patients suffering fromlong-term conditions (ALD), such as diabetes, cancer or even Alzheimer's disease, constitutes the heart of the intervention of theHealth insurance. Today, faced with growing budgetary constraints, its disengagement is being considered by the government, raising serious concerns from patients, but also health professionals. The solutions put forward all seem to present serious constraints, and even to be unpopular.\n\n

Solutions envisaged to ensure financing of care for people suffering from ALD

\n\n

Increase contributions

\n\nThe first solution consisting of increasing policyholder contributions raises a lot of resistance. This option could reinforce social inequalities in health, because the poorest people would be likely to forgo care due to its increased cost. In addition, this increase could weigh on the purchasing power of households.\n\n

Encourage private mutual societies

\n\nAnother solution envisaged is to encourage the intervention of private mutual societies. However, this option is also controversial. Indeed, it could lead to an Americanization of the French health system, where the ability to receive treatment depends on one's level of income. In addition, private mutuals can also select their members according to their state of health, thus excluding people with a high health risk.\n\n

Use progressive pricing

\n\nA final scenario could consist of implementing progressive pricing for care based on income. This measure would be more socially equitable, but it also raises difficulties. This option could in fact dissuade some people from seeking treatment due to the perceived cost, particularly for chronic illnesses requiring regular monitoring.\n\n

Few and controversial solutions

\n\nUltimately, the potential disengagement from Medicare towards the long-term conditions raises serious challenges. All the solutions put forward have drawbacks, and none seem to achieve consensus. The main difficulty lies in maintaining a balance between the need to sustainably finance the health system and guaranteeing access to care for all. \n\n