The speech delivered on January 6 at the South Ile -de -France hospital by the President of the Republic on the occasion of the presentation of his wishes to health professionals included a list of pleasant promises to hear for his audience: continuation of The revaluation of wages of hospital staff, increased payment of night work and weekends as well as guards and on-call duty, housing plan allocated in major cities, teamwork, relaxation of schedules for more stability, Increase in the number of specialized nurses called “advanced practice”, an essential role of clinical services, freedom of organization of establishments, end of activity pricing (T2A), governance shared between caregivers and managers.
These words were however marred by two untruths. Contrary to what has been said, the government did not increase T2A prices in 2018, it dropped them on that year by 0.5 % and did not read them, only 0.2 % , that in 2019. As for the 19 billion investments announced repeatedly, they are scheduled over ten years, include a share of debt and are not intended only at the hospital, but also in the city and medico-social.
For city medicine, priority has been reaffirmed to the first appeal (development of professional communities, doubly of medical assistants, increase in revenues from liberal doctors in exchange for their participation in the training of young people, permanence of care and the acceptance of new patients). No constraint, only incentive.
But the denunciation of the irresponsibility of patients “too many not to honor their appointments” refers to a liberal and individual vision of health where “applicants” and “providers” meet on a free market . This vision is incompatible with public health and collective solidarity for the use of a superior common good funded by the nation and “placed outside the laws of the market”, to use the words used by President Macron himself during The first wave of COVID-19.
to the private what is profitable
The fixing of the health insurance budget and its accounting regulation are the responsibility of successive governments. And they must assume the state of dilapidation of the care system and in particular the public hospital. This is not the consequence of the irresponsibility of individuals consumer care, but the fault of the rulers who have not adopted a caregiver’s ratio by hospitalized patient, which have not strongly supported multi -professional health homes and Health centers, which have not revaluated the prices reimbursed by Social Security to remove the excess fees, aggravating social health inequalities, which have not regulated the freedom of installation of doctors, and above all who have Accepted the growing privatization of health sectors.
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