reimbursement of long-term illnesses in the government’s sights

Reducing the treatment of these serious illnesses promises to spark debate. The government argues that the list of long-term conditions (ALD) should be updated.

The government is looking to save money. He has reimbursements for long-term illnesses in his sights. These illnesses risk being less well reimbursed by social security, even if for the moment, the government says it is reviewing these long-term conditions, serious illnesses such as cancer or diabetes, to name just these two examples.

Care for these ALDs (long-term illnesses), as they are called, is currently covered 100% by Health Insurance, at no cost to the patient. According to the Ministry of Health, this system benefits 13 million patients, but this figure is increasing very quickly with the aging of the population and advances in medicine, which lead to more expensive treatments. If the government is looking into it, it is because ALDs certainly concern 20% of policyholders, but they alone represent two thirds of Health Insurance reimbursements. That’s a total envelope of more than 110 billion euros in 2020.

A system put in place after the second War worldwide

The government therefore suggests that it will review the list of these ALDs, explaining that the system has existed since the creation of Social Security, after the Second World War. The executive believes that the list of these conditions established by decree, and on the advice of the High Health Authority, should be updated, because it has changed very little. A little over 10 years ago, high blood pressure was taken off the list, but that’s about it. Today, there are around thirty pathologies eligible for ALD.

The most common are diabetes, cancers, but also psychiatric conditions, or even heart or kidney failure problems. For the government, these pathologies should not necessarily be treated in the same way, or not necessarily for as long.

Socially, reducing the care for these serious illnesses promises to spark debates and turmoil, because these are major health problems that are falling on you. Is the government just launching a trial balloon? He still entrusted a mission on the subject to the General Inspectorate of Social Affairs and the General Inspectorate of Finance. In fact, the government also says that if Social Security reduces the coverage of these ALDs, complementary health insurance and mutual insurance companies will take over, at least in part, and that in the end, patients would not necessarily be worse off. reimbursed. Mutual insurance companies and complementary insurance companies nevertheless risk increasing their prices. If it’s a gamble, it’s risky!