Health: Chronic diseases in the government's sights to save money

Health Minister Yannick Neuder says he is open to the idea of re-evaluating the definition of care and reimbursements for long-term conditions (ALD), in a context where the government is trying to clean up the Social Security accounts.

According to the annual report just published by the Social Security Accounts Commission, in the absence of new measures to reduce expenditure or increase revenue, the deficit will be 24.8 billion euros in 2029, compared to 21.9 billion euros forecast for 2025.

The government is working on new avenues that could generate savings. Specifically, the management of long-term illnesses (ALD) is once again in the sights of the government and the Minister of Health and Access to Healthcare, Yannick Neuder . In this context, the latter spoke of "individual responsibility." The minister said he is open to the idea of re-evaluating the definition of care and reimbursements related to ALD, i.e., people suffering from a chronic illness.

A reassessment that would affect nearly 20% of the population. According to figures from the French Health Insurance Agency, 13.8 million people benefited from the ALD system in 2022. Specifically, they may soon no longer be reimbursed for medications that do not directly affect their serious or chronic illness. This long-term condition could also be withdrawn if they are in remission. These savings, combined with others, could generate at least €850 million, according to a report .

While the minister's office tempers the situation by specifying that "at this stage these are avenues for reflection," it is already too much for the associations. "It's all very nice, but he's not going to solve the problem like that," sighs Gérard Raymond, president of France Assos Santé , which represents patients. "These micro-economies that we're going to make will backfire on our healthcare system and the health of all our citizens. It will certainly cost us more in the future," he continues.

According to Gérard Raymond, this will cause delays in care, which will further increase health insurance costs in the future. There is also a risk of the burden being shifted to supplementary health insurance, which will lead to additional costs for the French people concerned.

Especially since the report specifies: the implementation of a co-payment "can generate significant savings but breaks with the principle of ALD". One consequence: "an increase in supplementary insurance contributions [...] The pricing of supplementary insurance contracts is based on age, these increases would have a greater impact on older people, who are more likely to have ALD."