Thursday, March 22, 2012

imperfect solution to the excess fees

imperfect solution to the excess fees
The complementary health will be almost forced to repay some doctors overruns. It remains to see how many private practitioners will volunteer to integrate the device.

A decree and a decree signed by Xavier Bertrand were published in the Official Journal on Thursday, trying to implement a solution against excess fees the most excessive.

As expected, the Minister of Health proposes to anesthetists, surgeons and obstetricians in sector 2 (free prices) to limit their excess fees to 50% beyond the "tariff Safely." It also requires them to perform at least 30% of acts without overshoot. Nothing compulsory volunteers receive in exchange for partial support of their social contributions. In parallel, complementary health (mutual, private insurers, pension funds) are imposed the obligation to repay the overruns to keep certain tax advantages.

The device must be expanded in the coming days. Another decree to impose additional pay as overruns in other medical specialties. With one difference: the doctors involved will commit to not charge more than 20% above the tariff Safely, on acts alone techniques (imaging, minor surgery ...). They can not in practice on clinical procedures and consultations.

Paradox: the device does not fully satisfied neither the doctors nor the supplemental insurers, not patients. While appreciating a "real breakthrough", the CSMF, the first organization of private practitioners, regrets that "practitioners of a sector is left out." Even the tone of the union side, the Bloc, the majority among the surgical specialties. A sector physicians are those who do not have the right to introduce overshoot. They should stick to Safely rates. But Medicare itself recognizes that such rates, frozen for years because of funding, will not match the cost nor the time nor the level of expertise and legal risk of surgical procedures .

Mutuality French, meanwhile, feared windfall: many surgeons already practicing anesthetists or overruns "moderate". They could grow to the the 50% tariff beyond Social Security, and receive in addition to the lightening of their burdens. Conversely, in areas with a concentration of very large excesses (Paris, Lyon, Paca ...), the Mutual fears that the track is "unattractive to practitioners" and therefore ineffective. For patients without supplemental coverage (less than 10% of the population), the problem will remain the same for them.

The solution is partial, imperfect, its success is not guaranteed. She still deserves to exist, after years of fruitless negotiations between doctors, health insurance and mutual agreements signed no tomorrow, and threats of intervention policies ever implemented.

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