in the tariffs a very sensitive element for surgeons

The appointment is eagerly awaited by the hospitals and clinics. At the beginning of the year, Xavier Bertrand had decreased by 1 rates of acts they charge to social security, to compensate an activity planned strong increase ( 2.6) and therefore to respect the budget passed by the Parliament in 2006. The Minister of health had also imposed on institutions to 560 million euros in savings, mainly on their purchases. And to forestall any bad surprises, it has set aside a part of the appropriations to be delegated to hospitals, knowing that for the time being, the latter are paid according to their activity to 35 of their budget. The Hospital Federation of France (FHF) had constantly, since then, to demand the release of these funds, representing a little more than 700 million euros, and increased rates of hospitals ("Les Echos" from June 30). At the same time, the national health insurance fund (CNAM) reported a skid significant expenditures of clinics since the start of the year (read below) and abuse characterized some settlements on the acts charged to social security.

Bringing together all the players this morning, the Minister of health does not announce a new tariff upheaval. Earlier this month, some to the Government, cherished the idea of overall raise hospital rates, or even to reduce those clinics. This scenario was ruled foul, including visibility on the activity of the hospitals. It would be an increase of 2.5 to 3 in the first quarter, but the Government will wait for the condition of the premises throughout the first half before taking any decisions in September.

Expenditures to soar

Same caution on clinics, challenging with virulence the statistics of the CNAM on soaring spending, arguing such a calendar effect.

The Ministry of health should, however, make several gestures: a recovery target of certain acts performed by hospitals and clearly undervalued, representing several tens of millions of euros. And clinics, a better consideration of the cost of certain medical devices (prosthetics, Staples, etc.) in the tariffs, a very sensitive element for surgeons. Another aspect important: the Government should unblock approximately half of the funds frozen for hospitals, is a little more than 300 million euros. Something non-trivial, while there is no indication that the objectives on the savings will be achieved and that uncertainty plane on the evolution of the activity. The Committee alert was also stressed, in its June report, on the fact that a "sensitive rehabilitation of allocations would run a serious risk of overrun of the national target of spending for Medicare with a magnitude greater than 0.75".

Hence the decision of the public authorities still keep in reserve a substantial part of the credits, to spare its back to school. The credo of Xavier Bertrand remains to give institutions the resources planned for 2006, neither more nor less. Finally, regarding the abuse and fraud, in addition to a message of firmness of the Minister (the indus should all be reimbursed), a circular should be published to clarify differences of interpretation between the social security and institutions on the pricing of certain acts.