What is the “rabbit tax” intended to stop the surge in missed medical appointments?

Health Insurance has launched an information campaign to warn in an educational manner about the “misuse” of the health system and to remind people of the basic rules of citizenship. Health insurance screenshot.

To make patients who cancel their appointment without warning responsible, the Senate wants to introduce a financial penalty which would be paid in part to the doctor.

I operated from 5 a.m. to 7 a.m. I started my consultations at 8:30 a.m. I saw one. Then two rabbits in a row. I’ve been waiting like an idiot for 40 minutes», laments this surgeon. “First 2 patients did not come. The 3rd was there. The 4th does not come, but in her place comes a friend of hers, unknown, to take her place, without calling, without asking. Like he was coming to the restaurant. What a day…. It’s starting to piss me off“, a young doctor despairs. On social networks, many of them testify, between exasperation and incomprehension, to the multiplication of “ rabbits », these unfulfilled appointments which are on the rise. So many lost slots that could have been allocated to other patients. A scourge, because if the hospital and emergency rooms are embolized, it is also because the French are unable to make appointments in town.

Read alsoThe Senate is alarmed by the drift in social accounts in 2022

To make patients who do not keep their appointments accountable, LR senators introduced a “rabbit tax” in the Social Security financing bill currently under review. Concretely, when an appointment with a local healthcare professional has not been honored by the insured, a lump sum will be charged to the latter. Its amount would be fixed by decree and allocated to Health Insurance. The amount can be paid directly by the insured person to their fund, taken from their bank account with their authorization or recovered, by the Health Insurance organization, from future benefits of any kind. “ Faced with problems of access to care, while there is a shortage of doctors, it is a way of reminding us that medical time is precious », justifies Corinne Imbert.

Already, last February, at the time of the examination of the Rist lawthe senators voted for an amendment establishing a “compensation of the doctor at the expense of the social insured person” who would not honor his appointment. In Germany, for example, patients pay 5 euros when making an appointment, the amount remaining with the professional in the event of no-show. But this time, the government seems convinced. “We must re-empower our fellow citizens. This is on average one appointment per day per healthcare professional.», Says Agnès Firmin Le Bodo. “Perhaps we will have to think about a system that goes further“. Already last April, Emmanuel Macron in an interview with Le Parisien also affirmed that it was necessary “give patients greater responsibility”announcing that “those who don’t come to appointments, we’re going to sanction them a little”.

A phenomenon that is growing

The lack of civility of certain patients, who do not even take the trouble to notify when they cancel an appointment, has irritated doctors for months. The profession had alerted the public authorities to this growing scourge. More than 40% of general practitioners report at least five missed appointments per week, according to a survey published Monday by our colleagues at “ Generalist “. The National Academy of Medicine and the National Council of the Order of Physicians estimated, at the start of 2023, that the phenomenon affected 6 to 10% of patients with an appointment each week. Nearly two thirds of these defections concern a first meeting. “Already in 2015, we conducted a survey of 2,800 doctors, which showed that on average doctors lost 40 minutes per day because of these “rabbits”. 71% of doctors noticed at least one or two appointments per day not kept», recalls Dr Valérie Briole, president of URPS Île-de-France.

Read alsoDoctors relaunch the battle over the price of the consultation

For its part, the National Health Insurance Fund (Cnam) cites an appointment cancellation rate which could be between 3 and 4%. It focuses more on pedagogy than on punishment. To this end, on October 8 it launched a national information campaign, with little rabbits waiting on chairs in the waiting room, in order to raise awareness about the proper use of the health system and the action to be taken in the event of cancellation of appointments. “We have just launched a campaign to make patients responsible and remind them of basic citizenship which consists of notifying them if they cancel an appointment in order to limit “rabbits”indicated to Figaro Thomas Fatôme, director of Health Insurance. We will continue this teaching“. The subject will also be on the agenda of the negotiations which reopened on Wednesday on the price of consultation and access to care between doctors’ unions and Health Insurance.

Denouncing a “scapegoat of users”, France os Santé, representing patient ociations, recalls that according to the public health code “doctor’s fees (…) can only be claimed for acts actually carried out” and calls for prioritizing user information campaigns as well as platform accountability. Because the phenomenon has accelerated with the rise of online appointment booking. Leader in the sector, Doctolib already sends reminder SMS to patients and prevents you from making an appointment over the same period with several doctors in the same specialty. Despite this, the problem remains.

Source link

Leave a Reply