In emergencies, the same price for everyone. Or almost…

Do you know the “emergency patient package”, the FPU? It is one of the many novelties of the 1er January 2022. The device should concern several million French people over the next few months. Voted within the framework of the Social Security financing bill, the FPU provides for a single rate for any visit to the emergency room that does not result in hospitalization.

Until then, Health Insurance paid 80% of the bill, the rest being borne by the patient – the famous co-payment. From now on, each user concerned will have to pay € 19.61 before discharge, regardless of the extent of the care provided.

→ DEBATE. Is it legitimate to charge for going to the emergency room?

The objective is laudable since in addition to capping the cost of going to the emergency room, avoiding unpleasant surprises for patients when receiving the bill, the FPU “Will facilitate the financial recovery of health establishments”, argues the general direction of the offer of care (DGOS). Good news for hospitals, most of whose debts are attributable to admissions to these departments.

Bad for patients, at least for the 5% of the population who do not have complementary health insurance. The FPU is not supported by Social Security, these 3 million “without mutual funds”, mostly unemployed and retirees, will have to pay ruby ​​on the nail. A single price for all? For some only …

At a time when the government intends to marginalize complementary services in favor of a more egalitarian “Grande Secu”, such a measure seems paradoxical. Admittedly, reduced tariffs and exemptions are provided for certain categories of the population, in particular beneficiaries of State Medical Aid (AME). It is also necessary for eligible people to have real access to it.

According to a report from the General Inspectorate of Social Affairs (Igas), 318,106 foreigners in an irregular situation benefited from it at the end of 2018. Far, far away from the 2.5 million people who could claim it … “Already far from care”, warns the NGO Doctors of the World, fearing that the poorest will give up healthcare.

This is a very radical way to relieve emergency rooms in hospitals. But will this have an impact on what doctors consider to be the main reason for this saturation: the excessive use of these services, monopolized by “bobology”? Nothing is less sure. “The measure is accounting while the resolution of the problem requires a major paradigm shift”, thus estimates Doctors of the World, pointing to the shortage of nursing staff, medical desertification, or the lack of regulation of primary care medicine.

And what about the difficulties that this may cause on the ground, while the fifth wave of Covid puts hospital staff to the test? Will the caregivers have to do the checkout themselves? Above all, will they have to ensure the solvency of patients even before examining them? “It will create tensions, over-administration”, anticipated an emergency doctor on RTL a few days ago. We have other things to do! ” Heal, for example.


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