Could it be a glass of water to put out the fire? Faced with the weariness of general practitioners, the National Health Insurance Fund (Cnam) proposed to increase the price of the consultation by 5 euros so that it increased to 30 euros. However, this increase is conditional on practitioners accepting additional commitments against medical desertification. In case of refusal, the consultation would be set at 26.50 euros.
The Cnam and its director general, Thomas Fatôme, began this Wednesday, February 22, a final session of negotiations with the unions of liberal doctors to try to reach an agreement on the prices of consultations for the next five years. The Cnam had already unveiled to the doctors' unions its proposal for a revaluation of 1.50 euros in the prices of consultations, thus bringing the basic consultation of general practitioners to 26.50 euros.
But she had not yet unveiled her proposal for general practitioners agreeing to engage in a "territorial commitment contract", which aims to increase the supply of care by doctors to respond in particular to the problem of medical deserts.
The territorial commitment contract asks doctors to commit to three subjects: "increasing the medical offer" (size and evolution of the patient population), "financial access to care" (respecting sector tariffs 1 or sector 2) and "the response to the care needs of the territory (participation in the permanence of care, unscheduled care, coordinated exercise)," Cnam told Agence France-Presse (AFP ).
"This proposal confirms the will of the Health Insurance to respond to the problem of access to care for all by strongly supporting the liberal doctors who engage in this same approach, in the logic of give and take", a- she clarified.
The doctors' unions are demanding a general increase that is much more substantial than the 26.50 euros proposed by the Cnam, to at least 30 euros, or even 50, without signing new commitments. "With this territorial commitment contract, we are creating something artificial, which leads to paying more than the basic rates of doctors who agree to overload themselves with work", explains in particular Dr. Raphaël Dachicourt, secretary general of ReAGJIR, a union of young doctors observing in the negotiations.
The negotiations, which take place at the headquarters of the Cnam in Paris, were still in progress Wednesday in the middle of the evening. They are due to resume Thursday afternoon. The Cnam and the doctors' unions must have signed the new medical agreement next Tuesday at the latest, otherwise the new agreement will be drafted by an arbitrator, Annick Morel, a former general inspector of social affairs.
