Health insurance: “Crisis reveals shortcomings”-Renne

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For nearly a decade before arriving in Rennes in 2013, he was the director of Caisse Primaire d’Assurance Maladie du Finistère. What are your ratings for these years?

Finistere is proud to have led a project to integrate the two Finistere Funds. This was a very important project. Even in Rennes, that time was not easy. In recent years, the general system has integrated new groups such as students and self-employed people. We also had to manage the increase in profits (+ 16% in 2021, editor’s note), which was a real challenge. And, of course, the health crisis happened there …

What was the impact of the Covid crisis on health insurance activities?

During the health crisis, the need for information exploded and we responded to numerous emails. The Rennes Foundation, which has practiced mutual aid on behalf of the network, is the fund that received the most emails in France. The method of discussion has changed, and the number of reservations over the phone has increased. Habits have evolved. And the implementation of contact tracing also required rigorous organization.

Claudine Quéric resigned as CPAM Director of Ille-et-Villene on Tuesday, May 24th.
Claudine Quéric resigned as CPAM Director of Ille-et-Villene on Tuesday, May 24th. (CPAM of Ille-et-Vilene)

This period brought a boom to the practice of remote counseling.

The crisis has contributed to the exponential growth in the use of digital technology. Certain barriers to conducting remote consultations have been specifically lifted. Even if the supply is currently well known, it needs to be regulated. This is a form of response to medical desertification, but raises the issue of the quality of follow-up by the same physician. Tele-consulting, yes, but not under any conditions.

Today, we see extended processing hours for sick leave, crowded receptions on certain hotlines, and more. There is pressure on the CPAM staff. What do you think about this issue?

We sincerely hope that the tight budget framework imposed on us will be more flexible. In the just-finished period, we did not have the right to replace 60% of departures. This includes not only retirement, but everything else such as transfers and resignations. This leaves no room for operation and results in a worsening of this deadline. We hope that the services provided and the agility we have shown will be recognized through decisions made at the national level.

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PHOTO NICOLAS CREACH / Telegram. (29) Morlaix work stop form, vital card, stethoscope, sphygmomanometer, health insurance, social security
Rennes CPAM is a large organization with approximately 1,000 employees (Nicolas Créach / Le Télégramme)

Do you also face difficulties in hiring health insurance?

It’s a little harder to hire than before, that’s true. Today, there are few unsolicited applications. Compensation issues also occur more often in our recruitment, primarily for the most qualified jobs.

Scams remain very small

In 2020, the Auditor’s Court pointed out the difficulty of obtaining reliable figures to correctly assess social fraud. Did you notice any improvement in this regard?

We continue to be mobilized in the fight against fraud. Given the financial masses involved and the number of people who will benefit from the various billing methods, we know that it can be a playground for fraudsters. We have developed digital control tools and set up a team of experts in the fight against fraud. Perhaps we can still do better, but we must not forget that it remains very marginal and that the vast majority of people behave as citizens.

What are the main challenges for health insurance in the future?

What is certain is that the crisis has revealed the shortcomings and limitations of the system. Health insurance as a funder still has a lot to do, but it also supports ongoing change. Especially regarding the establishment of a health community of territorial experts. Part of the population still needs to be supported, partly due to revolutionary and digital inclusion issues. Finally, we must continue to provide support for urban care to reduce the use of emergencies.