A minister to the front, in 10 steps

Tardivon Jean-Christophe/SIPA

Published the 23.10.2017 at 07: 30

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health publiqueéconomiePLFSS 2018

Almost unknown to the general public, but personality in the world of health (a specialist in blood cancers, with a global reputation, former boss of the INCa (National Cancer Institute) and the HAS (High Authority of health), Agnès Buzyn had not been slow to find its way to the media. His stand – courageous – on the issue of vaccination has revealed a determined woman ; a true illustration of ” the iron fist in a velvet glove… “. Expression exhausted, but that will certainly please.

Before you have to answer the questions of the deputies, on Tuesday, advancing to the assembly its first PLFSS, the Draft Law of Financing Social Security, still a little broken in the jousting policies – but it has the reputation of learning quickly, she pulled skillfully the first salvo in a long interview in the Journal du Dimanche. With a strong resonance in the media : “It’s going to save the health clinic” or ” The soft revolution “, which calls for a few comments. Why Doctor has taken the initiative to rank the top ten measures in 4 categories.

Of course !

• 1 : The Third-party payer widespread, generalizable…

A confirmation : “We will fulfill the commitment of the President of the Republic to make the third-party payer generalizable”. But, “we must continue our efforts to ensure effective enforcement everywhere. We are not ready technically to extend it.”

The third-party payer will therefore be generalizable, but not right away. A measure that will prevent – until when ? – the sling snorting of liberal doctors.

• 2 : The package at the hospital who goes from 18 to 20 euros

“A simple catch-up “. The measure, estimated at 200 million euros, is already gnashing of teeth of the patient associations and mutual societies taking care of these living expenses. “When the expenses of the mutual increases, what are the expenses of the French to increase,” and “their contributions”, said Thierry Beaudet, president of the Mutualité Française.

The minister fixed appointments

• 3 : 100% Reimbursement of glasses and dental care

An appointment ambitious that it will be probably considered to be : “I want to get there well before the end of the quinquennium. My purpose is to reach within a year.”

Other appointments : “In 2022, seven out of ten patients who come to the hospital in the morning leave in the evening, compared with five today. “

Finally, confirmation that farm for the mandatory immunization which will be launched in January for which she wants to ” not force to convince but compel to reassure “. The response in January 2018.

• 4 : Return on the universality of allowances

“When we win more than 8, 000 per month, is that it makes sense to get 32 euros ? “The minister therefore has no taboo on this subject and opens the door to the debate on the abolition of allowances for better-off families. “

A measure that should not put many people in the street and will help the government to dispel the suspicion that he is made to practice a policy too liberal.
 

Effects of ad … as the predecessors ?

With in summary always the same finding : “30 % of the expenditure of the sickness insurance are not relevant”.

• 5 : Hospital and bed closures

The usual discourse on ” the margins of manoeuvre to save money, without affecting the equality of chances “. And : “We will close the beds, which serve no purpose, or to reorient them to new needs “. The observation is not new. The hospital will be put to contribution.

Development of the ambulatory, that is to say, return the same day to the house after most surgical procedures. For hospitalizations less numerous and care in the city preferred. A very widely applied overseas for years (in particular in the United States or in Sweden) but that does not in France. Deficit explanation ? Growls of family physicians before increased responsibilities. A folder that should be clarified, beyond the announcement effect.

More again, even if it is in the pipes for a long time, the change of funding for hospitals, now being paid for the act, which will be experienced in the implementation of packages.

Finally, a measure that may be seen as a liberal extreme, but that is still in the debates among professionals : the “bonus and incentive objectives for hospitals” ; in the meantime additional comments of the minister, an idea more than a measure, but that is going to have the interest of starting the discussion.

• 6 : Excellence and high-tech

“The hospital should refocus on excellence and high technical skills “. A conclusion that a series of measures. Without being irreverent, it is even a kind of “cream pie” speeches of intent, in particular the use of robots, telemedicine, and social networks. It is obvious that their role will be critical. But who will the means : the government or the GAFA (Google, Apple, Facebook, Amazon and other communication groups…)

• 7 : Fight against fraud

3 billion euros in savings, “promoting the use of generic drugs and bio-similar” or fighting against the ” fraud and abuse “.

Again, this is in the wishful thinking in the face of a drift constant, but whose metrics – effective so without demagoguery – are struggling to put in place.

• 8 : The medical deserts

No coercion… ” I prefer a specialist area 2 be able to choose where he settled, but that in exchange, he would go to work one or two days per week in an area under-resourced. A doctor of fine neighborhoods will be able to do an advanced consultation in Seine-Saint-Denis “. We expect the comments of interested parties…

Of courageous political positions

• 9 : Increase in the price of cigarettes and tax Soda

Agnès Buzyn, confirms : “France has an abnormal behavior vis-à-vis tobacco. The only effective lever, that is, a price increase is constant over several years, which compels the smokers to prepare to stop. We know that a price increase of 10 % leads to a decrease of 4% in consumption.”

The price of a package of tobacco at 10 euros was a campaign promise of Emmanuel Macron.

For the sodas : “I did not wish to add a tax behavioural weighing on households. It is a proposal of deputies. The objective of the tax as it is designed would not yield more money, but to encourage industry to reduce sugar levels. Today in the stores, bottled water and soda, are almost taxed the same way, it doesn’t make sense. “

Probably, no one will contradict…

• 10 : The fight against sexual harassment

Agnès Buzyn admits to ” have had to deal with behaviour highly inappropriate in his professional environment “. With department heads who were telling him ” Come sit on my lap “…

Without giving in to the mode #denounces… she waits for ” that man rebelled publicly, alongside the women who react “.
 

Undoubtedly, Agnès Buzyn is a social asset for a president accused of drifting liberal. First response to the professor of haematology : it will undergo the test of fire policy Tuesday, defending the assembly its first PLFSS, the Draft Law of Financing Social Security. Asset, but also weakness, that is the number of critical issues which it is going to have to discuss.

In the meantime the home of professionals : his former colleagues in public hospitals, but especially the physicians that do not return to the reforms that they are waiting for and know, with force, via their respective unions.