Uno determination of the Social Finance Act of 2024 aims to reduce the cost of medical transport by taxi by reducing the price when shared patient transport is possible through a special reservation platform. On December 11, a nationwide taxi strike protesting this provision caused significant disruption to the lives of our citizens in major cities across the country.

The need to limit the social security deficit to 10 billion euros in 2024 is undisputed. Transporting several patients to the hospital in a taxi is a cost-saving option. Free ambulance services, light medical vehicles and taxis for patients cost social security €5 billion a year.

Certainly, this free service allows savings because a patient can refuse to come to the hospital if the taxi ride costs 120 euros for a return trip. This means that there is a risk that his disability will last longer and that social insurance will therefore incur higher costs. A free taxi avoids a patient having to stay in hospital for chronic treatment.

But the search for profitability is essential. If two patients take the same taxi, the cost goes down. In Guyana, where the vehicle fleet is poorly developed, shared health transport accounts for 30% of patient journeys, but the national average is only 15%. In Spain there is a shared health transport system that uses special minibuses.

Gaps that should have alarmed

A February 2022 National Assembly information report on medical transport proposed a comprehensive reform to improve its efficiency and reduce its costs. The price for a health taxi is at least 50 euros. The report showed wide variations in annual per capita costs by region. This puts the Provence-Alpes-Côte d’Azur region in second place with 72 euros. Reunion is at the top with 101 euros, while the Pays de la Loire region has a low average of 40 euros. The extent of the discrepancies should have alerted us to the danger of rejecting a provision that applies uniformly throughout the country.

Due to a lack of reform ambitions, the Ministry of Health only retained one of the MPs’ sixteen proposals, namely the price reduction and the mandatory use of a reservation platform. But it was illusory to hope to impose a reduction in income on taxis without prior consultation and without support measures.

On the afternoon of December 11, in the middle of a taxi strike, the Ministry of Health announced that it would forgo setting up a platform and offered a meeting with experts. This is the art of reform in France! The lack of dialogue with taxi tradesmen and support measures reflects a technocratic and centralized administration.

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