Health policy: "No to the demagogic project of Marine Le Pen"

Inspired by a policy of withdrawal, discrimination and divisions, and an identity drift, the program of the National Rally carried by Mrs.

Health policy: "No to the demagogic project of Marine Le Pen"

Inspired by a policy of withdrawal, discrimination and divisions, and an identity drift, the program of the National Rally carried by Mrs. Le Pen proposes a restriction of the access of foreigners, in particular conditioned to at least 5 years of work in France, RSA (Revenu de Solidarité Active), family allowances and AME (State Medical Aid) then relegated to the management of urgent care involving the vital prognosis. Does Ms Le Pen know the beneficiaries of this scheme? These are mainly young people with a worse health condition than policyholders of the same age, in extremely precarious situations, treated with medication for more severe pathologies. The AME not only has a humanist vocation but also a health one: this public health system does not only protect the beneficiary individual but also the entire population. Ignoring these patients could have serious repercussions, especially if they were to develop contagious diseases. Have we learned nothing from this pandemic? The economic impact being all the more minor: 0.35% savings on the health budget in France! Limiting access to care means allowing pathologies to develop into more severe forms, which will ultimately cost much more. And what doctor would refuse to provide care? Medical ethics cannot be traded as a political slogan.

Emmanuel Macron makes prevention a central point of his project, to allow us all to live in good health for as long as possible, by moving from a care system to a health system. Concrete proposals are put forward: health check-ups at key ages of life, for children early detection of disabilities, rare diseases and developmental deviations (hyperactivity?, dyslexia, obesity?...) and 30 minutes of daily sport at school, for patients with a chronic illness, personalized support? and connect?, and related detection and prevention plans? health? mental, has? infertility?, a? sickle cell disease... On the other hand, Mrs. Le Pen hardly mentions the subject and places herself on a completely different register, that of repression and the fight against fraud, with a narrowed and guilt-inducing vision. Who wouldn't want to crack down on all fraud? But this cannot become the main goal of an ambitious health program for our country.

Ms Le Pen declares a moratorium on the abolition of beds in public hospitals but maintaining the activity of all hospitals as they are, without mentioning their mission, nor their organization within the territory or their articulation with the medicine of town. What demagoguery! Today the hospital is in crisis and there is a deep malaise among caregivers. A pillar of our health system, the transformation of the hospital is a fundamental project that requires rethinking its missions and its organization in a territorial network. It is a question of developing a synergy between the different structures, with a good distribution on the territory, of optimizing the skills and perfecting the coordination. This will allow a decompartmentalisation of hospital/city, public/private and medical/social. At the same time, it is necessary to consolidate the liberal exercise of the health professions, and to increase the number of downstream structures by transforming certain structures into follow-up care establishments and respite homes. This project is clearly on the program of Emmanuel Macron, who wishes to open it, but through consultation with health actors, patient users and citizens, and local elected officials, relying on the territories, starting from needs rather than the offer.

Concerning the financing of the hospital, Mrs Le Pen's project is to return to a budget in the form of a global allocation with an expenditure envelope fixed a priori, which implies reintroducing all its faults: impossibility of coping with the increases in activity, the transformation of care methods, favoritism towards historically well-endowed establishments which thus benefited from a situational rent. Activity-based pricing (or T2A) also has its pitfalls and limitations, which come more from the choice of management indicators, which are purely quantitative and accountable, a source of the race for productivism, than from the very principle of the reform, which wanted to introduce a empowerment of actors and a search for optimization of the system. Does Ms Le Pen know that public hospitals are already partly funded by operating grants? Why not instead introduce a share of funding based on indicators of quality and relevance of care in order to break with the objective of financial profitability at all costs?

With regard to Europe, Mrs. Le Pen has officially given up on her exit, but her proposals will de facto get us out of it, but without saying so! Without Europe having guaranteed a supply and facilitated their distribution, we would not have had a vaccine against Covid19. Once again, does Mrs Le Pen know that Europe saves the lives of our fellow citizens? Other examples are authentic, with the European platform FOEDUS for the allocation of transplants, which allows when there is no compatible recipient in a country to reallocate the organ in another member country of the European Union. France receives more grafts for our pending recipients than it sends. Do we really want to get rid of all these help and saved lives?

And finally, how can we talk about health and the future without mentioning innovation and new technologies, which are largely absent from Mme Le Pen's programme. Healthcare innovation is both an evolution and a revolution that is already leading to significant improvements in the practices and skills of healthcare professionals, and in patient care pathways. This is an opportunity for France to be the spearhead of this change, and to seize this opportunity, a real economic lever of tomorrow, with other benefits that we must remember: improvement of the quality and safety of care, transformation of dependency management, personalization of care, and reduction of inequalities, all while increasing the overall efficiency of the health system. It is for these reasons that Emmanuel Macron has drawn up the 2030 health innovation plan to make France the 1st innovative and sovereign European nation in health.

We, health actors, have decided to support the candidacy of Emmanuel Macron and call to vote for him. Like Emmanuel Macron, we believe that health is a central subject for the next five-year term and first and foremost a dynamic and innovative sector that creates jobs and wealth. This is a major human and social investment for France, requiring a vision of global health where the protection of human health also involves that of animals and their interactions with the environment. We firmly oppose a regressive, narrowed, discriminatory, guilt-inducing vision and above all without any ambition for the future of our health system.

* The petitioners

Pr Patrick Pessaux, Head of Department of Visceral and Digestive Surgery, University Hospitals of Strasbourg, President of the French Association of Surgery, President of the Collective for Eco-responsibility in Health

And in alphabetical order:

Pr Marc Bardou, Head of Plurithematic Clinical Investigation Center Department, CHU Dijon, member of the group of experts for prevention and health promotion, Public Health France

Anne Beinier, PhD, Expert in social protection, European Commission

Dalila Bellouni, liberal nurse Aulnoy des Valenciennes

Dr Anne-Carole Bensadon, General Practitioner

Prof. Amine Benyamina, addictologist psychiatrist

Pr Sadek Beloucif, Anesthetist-Resuscitator, President of the National Union of Public Hospital Doctors (SNAM-HP)

Dr Nora Berra, Physician, Former Secretary of State for Health, President of Union for Global Health

Dr Martin Blachier, Public health physician, partner at Public Health Expertise

Prof. Jean-Pierre Blum, Public Health Officer UNESCO Bioethics Unit

Valérie Bougeard, Director of care, Director of IFCS-IFIS (IADE-IBODE-IPDE), CHU Nantes

Christèle Cerisier-Philippe, Health professional, director of Exploeyescar, community health referent Coeur Côte Fleurie, member of the board of UDCCAS du Calvados

Pr Brigitte Chabrol, Head of Pediatrics Department, CHU Timone, Marseille

Nicolas Choutet, Deputy Director of Operations Ramsay Health

Pr Olivier Collange, Intensive care anaesthetist, Strasbourg University Hospitals

Guy Collet, Honorary Hospital Director, former Director of ARH and former strategy advisor to the Fédération Hospitalière de France

Pr Jean Michel Constantin, Head of the Pitié-Salpétrière anesthesia-resuscitation department, APHP

Dr Florent Costantini, Ophthalmologist

Nicolas Cristol, Director in the Pharmaceutical industry

Dr Alexandre Delobelle, general practitioner in Marly, elected ordinal of the North

Julien Delpech, Founder Invivox, member of the board of French Healthcare

Dr Nhat Minh Do, Pediatric Dental Surgeon

Dr Nabil El Beki, Head of Emergency Resuscitation, Anesthesia and Multipurpose Medicine and Head of Follow-up Care and Rehabilitation at the Valenciennes Hospital Center

Dr Philippe Faucher, Coordinator of the Birth Control Federation of Eastern Paris, Department of Gynecology-Obstetrics, Trousseau Hospital, APHP

Dr Jacques Franzoni, General Practitioner, President of the CPTS Grand Valenciennes

Prof. Gérard Friedlander, General Delegate of the Paris Cité University Foundation, former Dean of the Paris Descartes Faculty of Medicine

Pr David Fuks, Head of Digestive Hepato-Biliary Endocrine Surgery, Cochin Hospital, APHP

Pr Pierre Fumoleau, Oncologist, former Managing Director of the Institut Curie Paris hospital complex, President of Matwin, President of the Scientific Council of the Foundation for Research on Precariousness and Social Exclusion

Dr Elisabeth Gaertner, Chief Physician of the Anesthesia and Resuscitation Unit, CH de Colmar

Dr Bertrand Galichon, Emergency Physician, President of Catholic Doctors

Dr Patrick Gasser, President of Avenir Spé

Lamine Gharbi, President of the cap Santé group

Luis Godinho, President of the Audioprosthetists Union, member of the High Council for the Future of Health Insurance (HCAAM)

Dr Saliha Grévin, Pharmacist, CPTS President of Grand Douai

David Gruson, Digital health business leader, former adviser to the Prime Minister for Health

Dr Benoit Guillon, Cardiologist Besançon

Dominique Guilloton, IBODE Health executive, IBODE school trainer, CHU Nantes

Dr Ghada Hatem, Chief Medical Officer of the Women's House (MdF)

Dr Didier Honnart, Emergency Physician, CHU Dijon

Dr Pascal Incagnoli, Anesthesiologist-resuscitator, CHU Lyon sud

Christophe Jacquinet, Co-founder of the Health Factory

Dr Fadi Jamal, Cardiologue, IzyCardio-CardioParc 

Pr Olivier Joannes-Boyau, Head of the Anesthesia-Resuscitation Unit, Bordeaux University Hospital

Anne Sophie Joly, President of the National Collective of Obese Associations (CNAO)

Danielle Juban, Vice-President Dijon metropolis attractiveness economic development health sector

Dr Abdo Khoury, President European Society for Emergency Medicine (EUSEM)

Dr. Philippe Leduc, Physician

Pr Michel Lejoyeux, Psychiatrist and addictologist, Paris Cité University

Dr Olivier Lepennetier, Emergency physician

Dr Mathieu Levret, anesthesiologist and resuscitator

Dr Olivier Mariotte, General Practitioner

Dr Pascal Maurel, Medical Journalist

Pr Guillaume Meurette, Visceral and Digestive Surgeon, Nantes University Hospital

Dr Gérard Milleret, Psychiatrist, former CME President of CHS la Chartreuse Dijon

Dr Benoit Morin, Liberal Gynecologist-Obstetrician

Dr Yên-Lan Nguyen, Anesthesiologist-resuscitation specialist, head of the risk and vigilance department, APHP

Prof. Karine Nouette-Gaulain, Head of the anesthesia and resuscitation department for women and children, CHU Bordeaux, Maire le Temple

Myriam Oukkal, President of the e-health council and co-founder of the Ecoresponsibility in health collective

Dr Patrick Pelloux, Emergency Physician

Prof. Franck Perrotin, Obstetrician Gynecologist, Head of Women's Parenting Unit, Tours University Hospital

Dr Guillaume Philouze, Visceral and Digestive Surgeon, University Hospitals of Strasbourg

Pr Julien Pottecher, Head of Anesthesia, Resuscitation and Perioperative Medicine Department, Strasbourg University Hospitals

Dr Nadège Poulain, Dental Surgeon, Valenciennes

Dr Guillaume Pourcher, Visceral and Digestive Surgeon, Institut Montsouris

Dr Nicolas Regenet, Visceral and Digestive Surgeon, CHU Nantes

Dr Stéphanie Rist, MP for Loiret, rheumatologist

Pr Lise Rochaix, Scientific Director of the Hospinnomics Chair, Professor of Economics at Paris 1, Panthéon-Sorbonne, Former member of the HAS college, and former President of the Commission for Economic Evaluation and Public Health.

Dr Noémie Roland, General Practitioner, Women's House of Saint Denis

Dr Dalila Serradj, Emergency Physician, CHU Dijon

Pr Didier Sicard, Emeritus Professor University of Paris

Dr Norbert Skurnik, Hospital Psychiatrist, President of the Paris GHU Ethics Committee Psychiatry Neurosciences

Morgane Soulier, Founder Feeleat, connected health consultant

Dr Sami Tayb-Boulahfa, Pharmacist, intern in internal medicine, President and founder of PHARMA Solidaires

Dr Jean François Thebaut, Cardiologist, Vice-president of the French Federation of Diabetics

Elisabeth Toutut Picard, Deputy Haute Garonne, Former Hospital Director, President of the GSE Groupe Santé Environnement

Pr Guy Vallancien, Member of the Academy of Medicine

Pr Eric Vibert, Surgeon, Villejuif Hepato-Biliary Center, APHP

Pr Yves Ville, Head of Obstetrics and Fetal Medicine, Necker Hospital, APHP

Pr Eric Vivier, President of Paris Saclay Cancer Cluster

Dr Solène Vo Quang Costantini, Dental Surgeon, Founder and President Hack Your Care

Prof. Pierre Wolkenstein, Dean of the Faculty of Health at UPEC

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