Decryption. “Shared transport,” new pricing... why taxi drivers are angry

Since Monday, taxis have been mobilizing en masse across France . A concert of horns, go-slow operations, bus network immobilisations, lane obstructions, towing operations ... the drivers are keeping up the pressure. This Friday morning, dozens of them were still blocking access to several Parisian train stations, as well as the A36 in Doubs , causing numerous traffic jams.

The object of their anger? The new framework agreement on medical transport, approved by the government on May 16 and which will come into effect on October 1. Indeed, according to the National Health Insurance Fund (CNAM), nearly 40,000 taxis are contracted to transport patients requiring regular or emergency medical care. They now handle the majority of these trips, alongside light medical vehicles and ambulances. These trips represent a significant portion of the turnover of some drivers, particularly in rural areas.

A single package at 13 euros

Through this new agreement, the government is seeking to save on medical transport costs (costs are reimbursed to patients), which reached €6.7 billion in 2024, including €3.1 billion for licensed taxis alone (+45% in five years). Specifically, starting October 1, the flat rate for medical transport will be set at €13 across the country—whereas it previously varied by department—with a €15 increase for departures and arrivals in major cities to compensate for time lost in traffic jams. In addition, a single kilometer rate will be set in each department, which will no longer depend on the times and days of transport. However, supplements are planned for the transport of people with reduced mobility or according to certain local specificities.

"More than half of the companies will suffer the consequences of these new rates, and there will be economic layoffs, there will be no choice," Dominique Buisson, secretary of the National Taxi Federation, denounced to Le Monde . "For some taxi companies, the kilometer will fall below one euro," he assured. For Marguerite Cazeneuve, deputy director of the Cnam, this new pricing will, on the contrary, be "favorable […] in two-thirds of the departments, particularly rural ones." "We are organizing medical transport better so that the cost is sustainable," also defended Thomas Fatôme, number one of the Cnam.

Another point of contention: the agreement aims to promote "shared transport" between multiple patients and reduce "empty transport," which was previously paid for by health insurance. This will involve the possibility of a 10-kilometer detour per passenger, with a maximum total detour of 30 kilometers. In addition, the waiting time for shared medical transport must not exceed 45 minutes.

If the patient refuses, they will have to pay upfront and will not be fully reimbursed. Transportation platforms in hospitals will be developed to facilitate the implementation of "shared transportation." While they have stated their willingness to negotiate on this point, the majority of drivers are opposed to this measure.

Discussions with Bayrou this Saturday

The latter are also upset by the end of automatic contracting after three years of operation. It will now be necessary to obtain the agreement of a local joint committee. This measure aims to restore the distribution of the taxi fleet across the territory, as some departments are significantly under-equipped with medical transport compared to others. Finally, drivers oppose the deployment by 2027 of the Electronic Online Billing Service (''SEFi''), presented as an administrative simplification to combat fraud, but which involves the installation of geolocation devices.

While the inter-union is calling for the "immediate freezing" of the agreement, its representatives will be received on Saturday at the Ministry of Transport, in the presence of Prime Minister François Bayrou . This will also be an opportunity to discuss the other bête noire of taxi drivers, VTCs, accused of unfair competition.