The executive presented its Social Security financing bill for 2023 on Monday, September 26, at the same time as its draft budget. After two years marked by the Covid-19 crisis, the government is counting on a deficit reduced to 6.8 billion euros, a marked improvement compared to 2022 (estimated at 17.8 billion).
Despite the slowdown in growth, the government is counting on more dynamic revenue than expenditure, with contributions boosted by inflation and rising wages. The bill does not include any measure on pension reform – even if the executive does not rule out introducing an increase in the legal age or the contribution period by an amendment – and emphasizes the prevention, the overhaul of nursing homes and the fight against social fraud. Franceinfo summarizes the major measures of the Social Security Financing Bill (PLFSS) 2023.
Tobacco, sexual health… The emphasis on “prevention”
The Ministry of Health wants to implement a “more offensive policy in terms of prevention”. It plans to offer a free medical consultation at three key ages, between 20 and 25 years old for primary prevention, between 40 and 45 years old to prevent the onset of chronic diseases and between 60 and 65 years old to detect the appearance of the first frailties. and loss of autonomy.
The government also wants to make free access to the morning after pill for all as well as screening for sexually transmitted infections without a prescription up to the age of 26. The bill also plans to expand the number of health professionals authorized to prescribe and administer vaccines. As well as a new increase in tobacco prices, indexed to inflation, to fight against smoking.
Savings in the health sector
The executive does not want “bringing new savings to hospitals”, assured the Minister of Health Monday at the exit of the Council of Ministers. On the other hand, the PLFSS foresees savings on radiology and biology services. Spending on drugs will be better regulated. The State is thus targeting 1.1 billion euros in savings on health products.
The Social Security budget for 2023 also includes a measure of “temporary regulation” aimed at young caregivers “out of school”, who will first have to practice as an employee or as a liberal “for a minimum period”, according to the Ministry of Health. The objective is to stem the explosion in the cost of temporary work for hospitals (from 500 million euros in 2013 to nearly 1.5 billion in 2018).
Regarding Covid-19, the envelope dedicated to the health crisis will be capped at one billion euros for tests and vaccines in 2023. The High Council of Public Finances (HCFP) judges that this envelope “risk of being very insufficient”.
A fourth year for interns in general medicine
The government wants to extend the internship for general medicine students by one year to four years. The objective of this reform desired by Emmanuel Macron is in particular to encourage them to settle in medical deserts. “It remains an incentive, I do not want it to be an obligation”, said Saturday the Minister of Health, François Braun, on the sidelines of a round table at the summer university for the start of the Modem, in Guidel in Morbihan.
In response, the main union of medical interns has already announced “a great mobilization” in October “going as far as the strike”to protest against this extension of their studies.
3,000 caregivers recruited for nursing homes
The executive intends to learn lessons from the Orpea scandal. Some 3,000 caregivers will thus be recruited in nursing homes in 2023, which represents an investment of 170 million euros according to the Ministry of Public Accounts. The government aims to recruit 50,000 caregivers in these establishments by the end of the five-year term in 2027. The nursing homes will also be affected by the tariff shield on gas and electricity prices in 2023.
Additional nursing posts will be created for elderly people with a loss of autonomy. The PLFSS also provides for the addition of two hours of social life per week in the assistance plans for the elderly with loss of autonomy.
Measures against social fraud
The fight against social fraud, the amounts of which detected by the State reached 1.5 billion euros in 2021, has been made a priority by the government, with a savings objective estimated at 180 million euros. The government wants to de-reimburse work stoppages issued by teleconsultation when these are not issued by the attending physician or a doctor consulted during the last twelve months, with certain exceptions.
The Minister of Action and Public Accounts, Gabriel Attal, promised Monday a better fight against fraud “by strengthening the power of cyber investigation of the social security funds, by better cross-referencing our files, by identifying more serious faults committed by health professionals and by acting on the subject of sick leaves”.
An independent committee responsible for combating social fraud will thus be created: it will be chaired by an independent personality and will bring together social protection players, experts and parliamentarians.
The revalued family support allowance
The government is planning a 50% increase in the family support allowance for single parents: it will drop from 123.54 euros per month and per child to 185.33 euros from November. The executive wants to invest 1.5 billion in children and the family, extend financial aid for the care of children from single-parent families until they enter college, at age 12, and systematize the payment of child support. in 2023 to fight against non-payment.
“We are going to lay the first bricks of a public childcare service”, also promised Monday Jean-Christophe Combe, Minister of Solidarity, Autonomy and People with Disabilities. The government thus intends to reduce the cost of recourse to a maternal assistant for parents, by reforming the supplement of free choice of childcare (CMG). It also wishes to simplify the delivery of daily allowances upon the birth of a child.