The Minister of Health announced in a press release on Thursday that dental costs would be reimbursed at 60% from October 1, against 70% previously. Mutuals will have to cover this 10% difference.
Bad news. The Minister of Health announced, Friday, June 16, that the coverage of dental care by Health Insurance will increase from 70% to 60% from October 1st. The moderating ticket, the part of the expenses which remains the responsibility of the patients, but often taken care of by the mutual insurance companies, “will go from 30% to 40%”. “This is not a drop in reimbursement, but a different distribution”Marguerite Cazeneuve, deputy director of the National Health Insurance Fund, told franceinfo.
To defend his measure, the Minister of Health, François Braun, starts in particular from an observation: “The field of oral care [est] historically focused on repair and healing”. This is why he wants to set up more regular prevention appointments for “younger generations (3 to 24 years old)”. The objective is to achieve ” future generations without cavities”he said in his press release, “and to reduce in the long term the recourse of the population to prosthetic and implant procedures”. Thus, we defend avenue Duquesne, this prevention must allow savings for patients, because “better prevention generates less expenditure, in terms of dental prostheses in particular”.
“Consequences on contributions”
However, these expenses have a cost and health insurance has a “constrained budget”. The ministry has therefore decided to focus this financial effort, amounting to 500 million euros, on mutual insurance companies. In the fall of 2022, parliamentarians had nevertheless adopted the Social Security financing bill (PLFSS) 2023, which decided to make contributions to mutual insurance companies up to “only” 300 million euros.
“Since the fall of 2022, regular discussions have been organized between the ministry, the complementary health services and social security., we stipulate to the ministry. The latter specifies that “the complementary ones were involved in the whole process” and that these last “expressed their desire to invest more in these prevention issues”. The ministry promised it: this change “will not generate additional costs for the insured, nor for the dentists’ offices”since “almost 97% of French people are covered by complementary health insurance”.
On the side of the mutuals, this financial effort is however difficult to swallow. “This decision will automatically have consequences on the contributions”reacted Thursday to AFP Marie-Laure Dreyfuss, the general delegate of the Technical Center for Provident Institutions. “It’s almost 2% more expenses reimbursed by mutual insurance next year”, abounded, Friday on franceinfo, Séverine Salgado, director general of the Mutualité française, which brings together a good part of the mutuals of the country. Gold, “these transfers will necessarily have an impact on the economic balance of mutuals”Who “unlike Social Security, cannot make a deficit and are now just in balance”.
“The Final Bill” for patients “will in fact increase”concludes Friday on franceinfo Séverine Salgado, who considers “premature” to try to estimate the increase that this will represent for patients on the price of their mutual insurance. “Each time the State transfers a charge to us, we include it in the contributions for the following year, to the nearest euro”, explains Fabrice Heyriès, general manager of MGEN, to franceinfo. “What remains to be determined is the translation of this increase into the numbers.
“It will not stop at these 500 million, because there are other public decisions which will intervene, including the revaluation of the consultation with the general practitioner.”
Fabrice Heyriès, Managing Director of MGENat franceinfo
The ministry maintains that it is doing everything possible to ensure that complementary health insurance does not pass on this additional cost to its policyholders. Added to this is the question ofPatients who don’t have mutual insurance. In the most disadvantaged categories, this concerns, “around 11 to 12%” people, estimated Friday on franceinfo Féreuze Aziza, in charge of health insurance mission at France assos health. She fears that many of them will give up dental care.
Ongoing negotiations
This decision was taken by the Minister of Health while conventional negotiations are underway with health insurance and dental surgeons until July 24. “These discussions aim for each of the actors to take a greater part in the financing, in particular, of oral prevention”, says the ministry. “We will invest health insurance money in these themes and we want to share these investments with complementary health insurance.
“It’s the chef’s surprise.” regrets Pierre-Olivier Donnat, president of the union of Surgeons-Dentists of France, contacted by franceinfo. “En the middle of the negotiations, we could have considered a better announcement. This is a very bad signal for the oral health of our fellow citizens”he adds, also pointing “a certain inconsistency on the part of the State which had assured to re-engage in the oral health of the French.”
If, at the end of these talks, no agreement was reached, an arbitration should be carried out, like what took place at the end of February with general practitioners. It resulted in an increase of 1.50 euro in consultations.