Health: Expenditure that grows exponentially outside of Covid

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Posted on April 19, 2022 at 7:01 AM

In 2022, budget slippage is approaching for the third consecutive year in the field of health. It makes no sense to expect the Alert Committee on compliance with the National Health Insurance Expenditure Target (Ondam) to propose corrective actions. The Social Security Financing Act of 2022 exempted this obligation this year. At least if the “significant risk beyond Ondam” is due to the cost of the fight against Covid-19.

In its opinion on April 15, the Commission “already estimates” that a provision of € 4.9 billion to deal with the epidemic was voted at the end of 2021 and “has significantly exceeded the risk.” The cost of screening tests in the first quarter is $ 2.1 billion, which is $ 500 million more than the annual provisioning amount. In addition to this, there are 600 million daily allowances associated with unexpected Covids. In addition, health insurance has just paid $ 1.2 billion “to respect vaccine and anticovid drug orders issued at the end of 2021”, which was not expected.

The fifth wave, which swelled in December, overturned all expectations before the tsunami in January with the Omicron variant. There will also be additional costs to cover in hospitals and nursing homes, the Commission reports, these facilities benefit from first semester funding guarantees.

“Careful monitoring”

If the current wave is down, the epidemic rebound that occurred in the fall is not excluded, so it is an extension of the measures to fight the epidemic. No one can tell the amount billed at the end of the year. It increased to $ 18.3 billion in 2020 and $ 18 billion in 2021.

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The cost of Covid-19 is not the only threat to the financial balance of health insurance. The Alert Committee “requires careful monitoring” of spending items that are skidding without being directly related to the health crisis. “The dynamics of this spending haven’t changed in 2021 compared to the pre-crisis situation,” he warns.

Spending on pharmaceuticals and medical devices increased by 8.8% in 2021, excluding Covid. That is, an envelope of 42.2 billion. The “safeguard clause” had to be enabled. This allows you to limit the amount of money refunded to a pharmaceutical company beyond a certain level of spending. The increase fell to 5.7% as discounts were negotiated elsewhere, but at a rapid pace.

Another exciting factor is the increase in “100% health”. In 2021, the government introduced a free offer of hearing aids and dental prostheses that cost $ 300 million (the offer of refunds for eyeglasses was not very successful).

Increasingly unreadable finances

In addition, the inflationary trend of five-year leave has not really subsided, rising from 6.1% in 2020 to 5.7% in the daily allowance excluding Covid in 2021. This is mainly for long holidays of 3 months or more.

Finally, there is the result of “Ségur de lasanté”, a reassessment of the 350 million social education sector funded from the range of health. The additional cost of “Ségur” in 2022 will be 2.7 billion after 7.8 billion in 2021 and 2.1 billion in 2020. To this, this summer, a reassessment of civil servant points will be added. The hospital will reclaim social security.

The 2022 Ondam should theoretically be down slightly from the 2021 record, reaching 236.8 billion from 239.5 billion last year. And spending increased by only 2.7%, excluding Covid and Ségur. Do you get there? The alert committee remains cautious. In addition to the “uncertainty” associated with the epidemic, he is also adjusting multiple hospital allocations throughout the year, offering unpredictable drug discounts, and making his finances increasingly unreadable. I’m pointing out. He sees his next opinion from the end of May to the beginning of June.