“The increase in the cost of energy promises to be stratospheric in the budget of healthcare establishments”

Lhe energy bill is not only exploding in the face of households and businesses, it is also entering the heart of the health crisis. The cost of energy is already shaping up to be stratospheric in the budget of healthcare structures, adding one more line in the very long litany of difficulties that caregivers and their management have to face. Budget forecasts for 2023 can only warn of the urgency of the problem: a sometimes sevenfold increase in the gas bill is planned, and, for electricity, the price per megawatt hour has already jumped from 85 euros to more than €1,000. All in all, an overall increase in the energy bill of the order of 100% is absolutely no longer unthinkable. Translated into euros, we must therefore expect an increase of at least seven figures for a medium-sized structure.

The dilapidated state of our hospital building stock will increase the bill even more, many structures being thermal sieves. A care establishment is however a monster of energy consumption: it is not only a question of heating the rooms of the patients, the treatment rooms, the operating theaters, or of preparing the meals, but also of operating the scanners , MRIs, to store patient data in rooms that must be kept at temperature.

If we add radiotherapy devices, freezers at – 80°C, fans and the ventilation of certain spaces, we quickly understand that the problem will not be solved only by an anti-waste campaign to make users and caregivers aware of the importance of turning off the light and the computer when leaving.

The increase in the energy bill simply raises the question of how to continue to operate our establishments without degrading the quality of care, even more crucial questions for certain structures already in financial difficulty. Existential questions of financial balance will inevitably follow this energy problem.

Activity-based pricing

In the business world, such an increase in production costs inevitably results in an increase in the selling price. This equation is strictly impossible in the economic model of health, because the prices of acts are not free. This is the principle of the now famous T2A (activity-based pricing), which is based on a specific reimbursement for each act, set annually by the State. The price of each act is understood as being “surrounded”, that is to say that it includes all the extras necessary to carry it out, including the caregiver’s salary and the cost of energy. All health expenditure is contained in an envelope which is itself closed, National Health Insurance Spending Goal (245.9 billion euros in 2023, an increase of 3.7% compared to 2022).

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