LAccording to a survey by supplementary health insurance, contributions to supplementary health insurance will increase by an average of 8.1% in 2024 French reciprocity. This means an additional withdrawal of 3.3 billion euros from the policyholders’ portfolio. Suffice it to say, financing our supplemental health insurance could be problematic this year, especially for millions of middle-class retirees.

In the short term, the government has the opportunity to stop this inflationary spiral by reforming the contracts that are unfairly viewed as “Responsible and supportive”, cornerstone of sector regulation. But in the medium term it will probably be necessary to work on the distribution of roles between public and private insurance in order to make health financing efficient and sustainable.

Almost all developed countries have a national public financing system, financed either by social insurance (e.g. Social Security) or by the state (e.g. the National Health Service in the United Kingdom). There is also a private insurance system, additional and not additional. Except in France, where private insurers play a complementary rather than additional operator role.

Because of the prominence of mutual societies before the introduction of social security in 1945, this decision was forced rather than made. France therefore continues to try to imitate two systems whose economic and social logic is nevertheless contradictory, which at present can only lead to failure.

Financial benefit or health insurance

Private financing is in fact regressive because it is not linked to income: the more the system expands, the more the middle class is punished. Additional health insurance reimburses you 30 billion euros of the 50 billion euros of expenditure are not reimbursed by social security, which certainly makes France the country where the last remainder is borne by households (7.2% of total expenditure according to the 2022 national health accounts prepared by the Directorate of Research, Studies, Evaluation and Statistics), for example, is half the OECD average (almost 15%). But is the end goal to achieve this financial performance or to ensure quality health insurance at a lower cost, particularly for the middle class? And France is doing very badly there.

In fact, the main obligation of the so-called “responsibility and solidarity contracts”, established by the law of August 13, 2004, which alone represent 96% of private health contracts, is the reimbursement of user fees. However, according to the 2022 public health bill, this market of 21 billion euros has no real insurance value for the insured. Because most of the risks lie in the remaining remaining components, which are very poorly secured.

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