What does the “Secu” budget for 2024, definitively adopted by Parliament, contain?

The text provides for savings on health spending and strengthened controls on sick leave and social contribution fraud.

The Social Security budget for 2024 was definitively adopted on Monday, December 4, via the rejection in the National Assembly of a final motion of censure against the government, tabled by left-wing deputies after the use of a new 49.3 by Elisabeth Borne.

Strengthening controls on sick leave, panties and menstrual cups reimbursed for those under 26, delivery of single medications in the event of a shortage, systematic screening for cytomegalovirus in pregnant women… Franceinfo summarizes what the document contains. final version of the 2024 “Secu” budget.

Three and a half billion euros in savings planned

To achieve its objectives, the government plans to find 3.5 billion in savings in health insurance expenditure: 600 million euros linked to hospital expenditure, 1.3 billion on health products (mainly reductions of medicine prices), 300 million on community healthcare, in particular analysis laboratories, and 1.25 billion linked to the “responsibility” of professionals and patients. Despite this effort, health insurance spending will represent 8.7% of GDP in 2024, compared to 8.2% before the Covid-19 health crisis.

An increased fight against social security contribution fraud

To fight against social security contribution fraud, the government wants to tackle the “under-declaration” of turnover of micro-entrepreneurs employed by digital platforms, a shortfall estimated at 800 million euros. By 2027, the platforms will have to collect these contributions directly. The text also creates offenses of incitement to social fraud but also of promotion and facilitation of fraud.

Reinforced controls on sick leave

To combat the increase in expenses linked to sick leave, the government has decided to strengthen the control powers of companies. From now on, the medical examiner mandated by the employer will be able to suspend the payment of compensation to the patient when he considers the stoppage unjustified. The health insurance fund may possibly decide to carry out a second examination. The text also limits the duration of stops prescribed by teleconsultation to three days, except for those prescribed by the attending physician.

Panties and menstrual cups reimbursed for certain women

Reusable periodic protection, i.e. panties and menstrual cups, will now be reimbursed for women under 26 and all beneficiaries of the Supplementary Solidarity Health Benefit. The text also enshrines in law free condoms for all insured persons under 26 years of age.

A “temporary status” for therapeutic cannabis

A “temporary status” of five years is granted to therapeutic cannabis, pending a marketing authorization decision by the European authorities. Already authorized in other European countries to calm the pain and anxiety of certain patients, medical cannabis was only authorized in France as part of an experiment which was to end on March 26.

Medicines delivered individually in the event of a shortage

In the event of shortages in the supply of a medication, single delivery may be made obligatory by order. Pharmacists will then have to issue “the right amount” to the patient’s prescription rather than a whole box. The government may also make it compulsory to carry out a rapid diagnostic orientation test (TROD) to deliver certain antibiotics.

A generalization of shared medical transport

From now on, patients who refuse an offer of medical transport (light medical vehicle or approved taxi) shared with another patient, without a valid medical reason, will have to advance costs and will only be reimbursed on the basis of the price of a shared transportation.

Systematic screening for cytomegalovirus in pregnant women

The 2024 Social Security budget makes systematic screening of pregnant women for cytomegalovirus (CMV), a virus that can affect fetal development. A three-year trial of a care pathway dedicated to “postpartum depression” was also added.

Towards diversification of hospital financing

Introduced in 2003, fee-for-service pricing in hospitals is often accused of having pushed establishments into a race for lucrative procedures and returns. The 2024 Social Security budget introduces two other financing methods, one based on “public health objectives” and the other on “specific missions”. However, this reform will not really begin to be applied until January 1, 2025.

Physical activity sessions reimbursed for cancer patients

For two years and on an experimental basis, health insurance will be able to reimburse adapted physical activity sessions for people with cancer.