The UFML is organizing the Assises du déconventionnement on March 3 and 4 with a view to organizing a massive exit of GPs from the convention which binds them to Health Insurance.
This February 28 was the deadline set for the discussions between the unions of doctors and the Health Insurance on the tariffs of the consultations. The negotiations were unsuccessful. Faced with this impasse, doctors threaten to come out of agreement. “Tonight we are burying the 2023-28 convention, on March 3 and 4 we are opening up to a new future”, announces Jérôme Marty, the president of the French Union of Free Medicine (UFLM), which is organizing the Assises du Déconventionnement on March 3 and 4. A future that could, according to him, concern thousands of liberal doctors.
France 3 Provence-Alpes answers 5 questions on what the implementation of this threat addressed to the government would imply, both for these doctors and for their patients.
- What is deconvention?
Non-conventional general practitioners go beyond the framework of the convention which notably establishes the quotation of their acts at 25 euros, everywhere in France. These practitioners will then freely set the consultation rates, which may vary from one territory to another.
“We do everything not to be kicked out of the convention, unless we are kicked out”, explains to France 3 Provence-Alpes Jean-Marc Bensoussan, independent doctor in Gignac (Bouches-du-Rhône), member of Doctors for tomorrow. The collective had called for a strike on January 2 to demand a consultation at 50 euros for all GPs.
The UFML brandishes the threat of a massive deconvention of doctors. “It’s completely irresponsible to call for this type of behavior, we consider ourselves a partner of doctors, we want to build better access to care with private doctors”, reacted Thomas Fatôme, the general manager of the Cnam, invited on February 27 in the program C to youon France 5.
- What would that imply for unconventional doctors?
Disadvantaged doctors could freely set their rates, but that means that their care would then no longer be reimbursed by Medicare.
For Dr. Bensoussan, however, the deconvention has other advantages. “We are not all going to go to 50 euros, it will depend on the territories, but the acts will be much more profitable and faster because we will not have all the paperwork to do, and a disappointing doctor will be able to give more time for the treatment.
- What will be the effects for the patients of these doctors?
Invited on France Inter on February 27, the Minister of Health François Braun estimated that the deconvention “would penalize the French even more by creating a two-speed medicine”.
The patient who will keep his non-contracted attending physician will have to pay for the consultation and whatever the amount, he will only be reimbursed by Medicare up to 0.61 euro. It is up to the mutuals to possibly complete the rest.
“Patients will not pay more for medicines and they will always have the same access and the same rights to physiotherapists and medical professions, ensures for his part Dr. Bensoussan. Medications and essential procedures will continue to be reimbursed by Social Security.
Patients could always decide to change GPs, but it should be remembered that some 6 million French people are already currently without a doctor.
- Is it really credible to envisage a massive deconvention?
“We will only do it if it is collective. And when we have between 15,000 and 25,000 promises of deconvention from doctors, we will send it to the government”, said Jérôme Marty in THE Parisian February 27.
Jean-Marc Bensoussan thinks that certain territories “suffering” will be greatly affected. “In some places, where patients have become accustomed to consuming care for nothing, there will be a lot of deconvention to improve the quality of care (…) We are forced to refuse people regularly because we have too many people and in return we have a lot of people who make an appointment and who do not come, it will empower the patients too.
At present, only 572 general practitioners are deregistered against 111,381 general practitioners and contracted specialists as of December 31, 2021, according to figures from Health Insurance, reported by The Parisian. 2,000 doctors are currently registered for the Assises du Déconventionnement which will be held on March 3 and 4, at the end of these meetings, they could take the plunge and send their letter to Social Security, hoping that the movement will take off. of snow.
The Minister of Health said he was convinced that the number would remain low, especially as the approach is not supported by the first union of doctors MG France.