Accounts in the red, savings in sight: the Social Security budget (PLFSS) which is to be presented on Thursday will not escape the effort to reduce the public deficit desired by the Barnier government.
Here are some figures and ideas for savings or additional revenue that have leaked out so far.
– Uncontrollable deficit
Driven by inflation, the Social Security deficit is spiralling out of control: in June, the Social Security Accounts Commission estimated that it would reach 16.6 billion euros in 2024, compared to the 10.5 initially programmed in the budget adopted last year.
The bill is expected to get even heavier. It will be "a little less good", said last week, during a hearing in the Senate, the director of Social Security Pierre Pribile.
According to Les Echos, without savings measures, the deficit could even approach 25 billion in 2025.
The government is therefore planning a drastic tightening of the screws, as it did for the state and local government budgets. According to the indications it provided last week, Social Security will have to find around 13 billion euros in savings next year, or a third of the 40 billion announced for the entire public sector.
– Retirement
To save 4 billion euros, the government announced that it would postpone by six months the revaluation of pensions, which usually increase in January according to inflation. But in the face of strong opposition from parliamentarians, particularly from the RN, Matignon said on Friday that it was "open" to other solutions.
Arrests
Work stoppages are in the crosshairs. The related expenses, which are rising sharply, could "exceed 17 billion euros" by the end of the year, according to the director of Health Insurance, who recently called for the system to be transformed.
In May, the Court of Auditors proposed extending the "waiting period" (the first three days of sick leave not reimbursed by health insurance, often compensated by companies).
According to Les Echos, the government is instead considering lowering the compensation ceiling.
Today, health insurance pays, from the 4th day of sick leave, an allowance equivalent to 50% of the daily salary, within the limit of a ceiling of 1.8 times the minimum wage, which the government would like to reduce to 1.4 times the minimum wage, in order to save some 600 million euros.
Contributions
According to a project presented to the trade union organisations, the government would like to distribute the reductions in employer contributions, currently heavily concentrated at the minimum wage level, differently so that the lowest paid employees can receive increases more easily.
In addition, the new cocktail of reductions would stop at 3 times the minimum wage, compared to 3.5 times the minimum wage today. The reform would make it possible to collect some 5 billion euros per year over three years.
Medical consultations
According to Les Echos, the government is also considering reducing the share of health insurance in the reimbursement of consultations with the doctor, by increasing that of complementary health insurance, which should in turn increase the prices of complementary insurance.
The Ministry of Health has not confirmed the information at this stage. The supplementary funds estimate this transfer of charges at 1 billion euros.
– New expenses
The hunt for savings is all the more difficult as new expenditures are planned.
An agreement concluded in June between the National Health Insurance Fund (CNAM) and the unions of independent doctors provided for various increases in consultation fees, with a staggered entry into force between December 2024 and 2026, representing additional expenditure of 1.6 billion euros in the long term.
The addition could however be reduced by the commitments made by doctors in terms of "relevance" and therefore reduction of prescriptions: medication, sick leave, medical transport or imaging and biology procedures.
The health insurance also hopes to save 420 million euros by combating fraud. It would also like to reduce avoidable hospitalizations and limit the waste of health products.
The Minister of Industry warned the pharmaceutical industry: "efforts" and "difficult decisions" will be necessary, particularly on prices.
– Hospitals in deficit
Hospitals and medico-social establishments are in a difficult situation. The public deficit of hospitals is expected to reach 2 billion euros in 2024, according to the Federation of Public Hospitals. It is calling for an increase of 6% in the dedicated envelope compared to last year, to 111.9 billion euros.
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