associations of patients suffering from long-term conditions are concerned about the proposed reform of their care

In an open letter addressed to the Minister of Health, 25 associations of chronically ill people fear that the Social Security ALD system will be called into question after the government’s declarations.

Patient associations are concerned about the questioning of the system for caring for long-term conditions, in an open letter published Wednesday March 6. These serious chronic diseases, also called “ALD”, 20% of French people suffer from them. Being classified as ALD means that health expenses are covered in full by Social Security. The Minister of Health Frédéric Valletoux said he wanted “question relevance” of the device.

The Minister of Health denies wanting to save money. But in the context where the government is considering ten billion euros in savings across all sectors, Frédéric Valletoux recognized at the end of February in the National Assembly that a reflection was underway on the system for long-term conditions: “You know that long-term illnesses concern 20% of our fellow citizens, that is to say 13 millions of French people who are thus supported in their pathology. This represents two thirds of reimbursements by Health Insurance. And therefore, it is not illegitimate, nor illogical, as has been regularly done, to question the relevance of these devices.declared the minister in the hemicycle.

“We also know that these ALDs, with the aging of the population and the rise of chronic pathologies, will mean that these envelopes will only increase.”

Frédéric Valletoux, Minister of Health

in front of the deputies

Wednesday, in the newspaper The worldthe Minister of the Economy Bruno Le Maire questions “the drift in expenses linked to ALD”. For the moment, there are no further details on this reflection and what follows. But ALD patient associations are worried about the 13 million French people who suffer from cancer, Alzheimer’s or even diabetes and who benefit from the ALD system. These are, in short, the sickest French people, with the most serious pathologies. And this is the principle of French Social Security, their health expenses are covered entirely by national solidarity.

It is their “Secu” expenses which are covered, patients must still pay significant out-of-pocket expenses, as recalled by Féreuze Aziza, health insurance project manager at France Assos Santé, invited on Franceinfo on Wednesday. Care related to ALD “are covered at 100% of Social Security rates”but there is also “fee overruns”, “medical franchises” or “the hospital daily rate” including these patients “are not exempt”. “These are expenses that are the responsibility of patients”says Féreuze Aziza.

“This is what makes us fear the worst for these patients”

In their open letter, the associations refuse a “dismantling” of the ALD system. The Renaloo association, which represents kidney patients, explains for example that “yes, the survival of dialysis patients costs a ‘crazy amount of money’, almost 63,000 euros per year per patient, but it is to the credit of our country.”

“This allows 57,000 people in France to stay alive, even though their kidneys no longer work.”

Renaloo Association

in an open letter

The open letter also explains that patients should not be made to feel guilty. They did not choose to be seriously ill. She finally explains that it is not in the pockets of patients, the most fragile links in the system, that we should look for money. “We’re going to save money on the backs of patients.”also denounced Féreuze Aziza, health insurance project manager at France Assos Santé. “It worriesshe confides, we put in parallel the search for savings, the questioning of the ALD system and the cost of chronic diseases.”

For France Assos Santé, “we must rather try to avoid chronic illnesses rather than avoiding the sick. We are not going to make the sick disappear by revising reimbursements or by attacking the basket of care”. Feruze Aziza “completely agrees with the findings” from the Minister of Health who points out that the cost of treating chronic diseases will increase due to their increase. But she pleads for more “prevention” while having “the courage to invest for the long term” with a “multi-year vision of health financing”.