Posted on April 13, 2022
I analyzed the health programs of Emmanuel Macron and Marine Le Pen.
Which offers the most credible solutions to restore the health system that has fallen to 24th place?
In his Letter to the French of March 3, candidate Macron wrote that he wanted “preserve and even improve this social model that we hold so dear and that has proven its worth. More solidarity between generations, prevention, health democracy, these are its guidelines.
What would you do after your re-election? The story is about to be written. In fact, I have analyzed the obstacles that he himself erected. They are numerous because the path chosen by the former president is too statist with the ineffective Ségur and the Grande Sécu.
Marine Le Pen’s is similar in many ways to Éric Zemmour’s but it is not complete.
Protecting the complementarity of the public and liberal dual health system by insisting on the territorial network of independent health actors (doctors, pharmacists, analysis laboratories, etc.) would be good, but it is vague.
Let’s take a closer look at their proposals.
Guarantee Social Security for all French people and the reimbursement of the four risks: illness, accidents at work, old age and family.
They are already covered by health insurance, so nothing new so far. It does not specify what price would be updated, nor the reimbursement rate.
Create a fifth risk of Social Security dedicated to age-related dependency, loss of autonomy or disability.
With what financing?
she wants to raise him “Avoid the massive use of foreign doctors and allow the substitution of too many planned retirements.”
It would have to be doubled, but that would only take effect in ten years. Preventing or limiting the number of foreign doctors would aggravate medical deserts and paralyze the hospital.
Marine Le Pen proposes modulating the remuneration of consultations according to the doctor’s place of installation.
This is typically the type of measure that is not applicable.
There is a shortage of doctors in all departments and in all specialties. Paying more for the consultations of those who are installed in such a place in such a specialty would be frighteningly complex.
It would be installed in areas with a shortage of doctors. It is pure utopia, the boarding school being a training.
Maintain local hospitals.
Instead of organizing territorial hospital groups (GHT) and increasing the number of public hospital workers. With what staff?
Fight against deficit and fraud
Eliminate state medical aid and replace it with aid restricted to vital emergencies
The AME is aimed at foreigners in an irregular and precarious situation. Every year tens of thousands of operations are carried out on non-European nationals without urgency and the regulations are not always complied with.
Fight various health insurance fraud.
In particular, by creating a biometric vital card merged with the national identity card. The fraud would be around between 15 and 45 billion euros according to Charles Prats.
sell the drugs to the unit
To save money, fight international trafficking and reselling. This management would be complex and a source of errors for some patients.
Accelerate and facilitate the implementation of generic medicines
True, they are less expensive than the original drugs. But some do not have the same efficacy, which could be dangerous, especially for hormonal and cardiovascular treatments.
Increase funding for scientific research.
In particular biomedical, to promote French technologies on the international stage and support new French companies.
The reform of medical studies and the general reorganization of the system are discussed. These are the only measures that could save the system.
The return to the selection and elitism is barely outlined. Reestablishing the republican contest created by Napoleon in 1802 and abolished in 2002 would be a good sign.
Currently it would be necessary to train 12,000 interns each year. Fewer than 9,000 are admitted to the first year of boarding because 18% were missing this year, forcing more than 200 foreign boarders to register.
Health organizations and general organization
Marine Le Pen intends to abolish the Regional Health Agencies and entrust the supervision of the hospitals to the regional prefects. It would be a healthy measure to release attention. What would be the role of the mayors of the big cities?
To deal with the shortage of nursing staff in the public hospital, he wants to hire nursing staff en masse, claiming that 30% of the positions are not filled. That’s correct, but it doesn’t say how to train and recruit them. Going back to 39 hours instead of 35 would make this transition easier.
All these measures will not be enough to restore the health system, due to the lack of a general reorganization that simplifies the administrations and due to the lack of review of the training of doctors and interns.