High load remains renunciations to care, neglected regions … Six years afterhaving severely criticized the management of dental care in France , the Court of Auditors again draws the alarm. Since 2010, the situation has even “worsened”, she argues . In its annual report on Social Security , published on Tuesday (September 20th), the Court denounced the “disengagement” and “wait- and- see” of public authorities in the sector and called on them to take strong measures.
Regretting a “continuing erosion” of the health insurance coverage, the Court notes that it only reimburses 33% of the € 10.6 billion of dental expenses. The supplementary insurance funded 39% and the insured 25%. This high-cost remainder would have pushed in 2012 nearly 4.7 million patients to give up prosthetic care, the most expensive care. Consequence: the oral health status of the French population is “mediocre”.
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Three days before they were launched on Thursday, 22 September, the Court of Auditors therefore placed its proposals on the program of negotiations between the Medicare, complementary healthcare and dental surgeons’ unions. They must set rates for the next five years. To facilitate the access to care , say the judges of the Rue Cambon, the social security will require the “counterparties” on the part of dentists.
The three tariff revisions granted since 2006, for an annual amount of 160 million euros, have indeed not succeeded in checking the continuous increase of overruns of fees on prosthetic procedures. They account for 62% of dentists’ fees for only 12% of their actions. The share of these overruns in total fees has “continuously increased from 47.9% in 2005 to 52.5% in 2014” . “No measure of medical control of the expenditure has been implemented” , regrets the Court.
The risk of strong hostility among dental surgeons
It makes eight recommendations, including some shock proposals. The ” selective agreement” of dentists, which would better regulate the settlement of newcomers, is already on the menu of discussions . The ” legislative” ceiling on tariffs for the most frequent prosthetic acts is likely to come up against strong hostility from dental surgeons.
If the negotiations were not able to determine an “effective and therefore binding regulatory framework” , the Court proposes that the Security Council should concentrate on 100% care of conservative and surgical care, leaving complementary health care Prosthetic treatments with capped rates.