After two years of the Covid-19 pandemic, numerous demonstrations by caregivers and cascading resignations at the public hospital, health is an essential theme for the candidates for the 2022 presidential election. And in this health chapter of the programs, the question of medical deserts occupy a central place.
Anne Hidalgo, the Socialist Party candidate, and Yannick Jadot, the EELV candidate, but also Valérie Pecresse, LR candidate, want to force young doctors to spend one to several years in these territories neglected by practitioners. Jean-Luc Mélenchon wishes to impose a place of installation for ten years on young doctors in return for better remuneration. Emmanuel Macron and Fabien Roussel, for once, are on the same wavelength and offer to go further. The candidate president and the leader of the Communist Party wish to regulate the installations of the doctors, that is to say that the latter could no longer settle where they want.
On the far right, Marine Le Pen and Nicolas Dupont-Aignan rather defend the establishment of bonuses for doctors who choose to settle in a medical desert. Encourage rather than compel. As for Eric Zemmour, the Reconquest candidate wants to hire a thousand doctors with employee status to assign them to areas where there is a lack of medical supply.
All the candidates agree on the fact that the public hospital is in bad shape and that it is necessary to recruit more caregivers. Nathalie Arthaud and Philippe Poutou want to increase the salaries of the medical professions (by 400 euros per month), as does Yannick Jadot (a 10% increase for all caregivers). Valérie Pécresse wants to hire 25,000 additional carers at the public hospital but does not foresee a salary increase. She also wants to reduce administrative positions. Marine Le Pen plans, if elected, to release two billion euros to raise salaries, especially those of nurses.
This presidential election also sees the appearance of a fundamental debate on the financing of health and the very controversial pricing by activity. Established in 2004, the “T2A” is the most important source of funding for hospitals, both public and private. In this system, establishments are remunerated according to the medical activity they carry out, from the installation of a knee prosthesis to an appendicitis operation.
This system today is criticized by some caregivers. According to them, fee-for-service pricing transforms the hospital into a business with the risk of favoring the procedures that bring in the most profit to the detriment of patients. Several candidates propose to put an end to this system, such as Jean-Luc Mélenchon, Yannick Jadot and Fabien Roussel or Nicolas Dupont-Aignan.
This logic of health preserved from the logic of profitability also underlies the debate on the role of private mutuals. Jean-Luc Mélenchon and Jean Lassalle propose to put an end to it, social security taking responsibility for the entire reimbursement of health costs.