Health. How state medical aid crystallizes tensions

Health.  How state medical aid crystallizes tensions

State medical aid (AME), which the Senate wants to abolish, is “a public health system” which must be preserved according to the Minister of Health Aurélien Rousseau.

Thousands of doctors mobilized

SATURDAY, 3,500 doctors have announced their intention to “continue to treat these patients for free” – mainly undocumented immigrants – if the system were to disappear. Doctors who will “not be paid” if they are liberal. And at the hospital, “I can not declare a consultation […]. This will be at the hospital’s expense. It’s my decision even if it’s against the usual hospital rules,” specifies Fr.r Antoine Pelissolo, one of the initiators of the text. Among the signatories are emergency physician Patrick Pelloux, Julie Chastang, vice-president of the College of General Medicine and nephropediatrician Rémi Salomon. Last week, 3000 caregivers had already signed an appeal has preserve AME in the name of public health.

The Senate restricts the basket of care, but…

On Tuesday, the Senate voted to delete it from the immigration bill, to replace it with “emergency medical aid”. With a reduced basket of care, according to them: only urgent care, serious illnesses, acute pain, care related to pregnancy or even vaccinations would be covered. In other words… more or less what state medical aid already provides : it only covers, subject to resource conditions, emergency care, treatments intended to prevent the spread of an infectious disease, care of pregnant women and their newborns, abortion and care intended for minors . You must have been on French territory for at least three months to benefit from it.

What are the risks of removing the AME?

The senators were careful not to abolish the AME purely and simply, despite its cost of 1.2 billion euros. Firstly for public health reasons: the system allows the monitoring and treatment of pathologies, possibly contagious, likely to spread and/or worsen. Then, for budgetary reasons: treating a patient later costs more. Above all, in the hospital, he will be treated in any case. Without the AME this would amount to a net loss for the hospitals’ accounts… but the care would be provided, and ultimately paid for by the community, in one way or another. The Federation of Public Hospitals considered Wednesday that this vote was “heresy”.

What will the Assembly do?

After the Senate, the National Assembly will have the last word in December on the bill. Most of the elected representatives of the majority and a good part of the left should, barring any surprises, restore the AME there. The minister of the Interior Gerald Darmanininitially in favor “on a personal basis” of a reform, no longer wants it “in the final text”. “The government is fully aligned. […] We will never switch to an emergency medical aid type system,” Aurélien Rousseau confirmed on Sunday: “If we send everything back to the hospital we will make a huge mistake. »

Two complaints against senators… doctors

Two doctors also filed ordinary complaints on Friday against two of two senators… doctors: they accuse them of violating, by their vote, at least five articles of the public health code – including the one which states that “the doctor must listen, examine, advise or treat with the same conscience all people whatever their origin, their morals and their family situation, their membership or non-membership of a specific ethnic group, nation or religion, their disability or state of health, their reputation or the feelings he may have towards them. He must support them in all circumstances.”

According to them, it also contravenes the Hippocratic oath, which provides that a doctor must “protect all people, without any discrimination, if they are weakened, vulnerable or threatened in their integrity or dignity”.

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