Among the savings measures announced by François Bayrou in his plan for the 2026 budget, several concerns the health sector. The Prime Minister notably announced a reform of the status of long -term conditions, considered too generous, based on a comparison with the German model.
“20 % of French people are in long -term condition against 5 % of the German population,” assured François Bayrou during his press conference, available here. We will therefore initiate an in -depth reform of the care of these conditions with from 2026 measures aimed at leaving the reimbursement at 100 % of the drugs which are unrelated to the declared condition […]and also to push that one can get out of the long -lasting affection regime when the state of health no longer justifies it ”.
The long -term affection system allows patients with a condition whose “severity and/or chronic nature require prolonged treatment and a particularly expensive therapeutic” to benefit from a reimbursement at 100 % of its health costs. The list of affections recognized as “long -term”, which includes Parkinson’s disease or cystic fibrosis, is available on the health insurance site. The ALD can also be “not exempt”, for when there is no expensive treatment, and allow you to benefit from a sick leave of more than 6 months and the management of transport, under certain conditions.
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Despite what François Bayrou asserts, the equivalence between the French system of long -term conditions and the systems for covering German health costs is far from obvious. This is what Zeynep Or, research director at IRDES (Research Institute and Documentation in Health Economy) details and co-author of a healthcare spending report in France and Germany: “The ALD system like the one we have in France does not exist in Germany. In France, the patient still participates in part of the costs: ambulatory visits, hospital … In Germany, there is no co-payment for medical visits, no cost for the patient, whether for a general practitioner or specialist ”.
Patients, on the other hand, participate in the financing of prescribed drugs, transport and care provided by non-medicine professionals. “Overall, this corresponds to 10 % of the cost or maximum € 10 per prescription for drugs,” says Zeynep or. But these expenses are capped for the entire population at 2 % of gross annual income, as explained by the German Ministry of Health. For patients with chronic diseases, for whom these expenses can accumulate over time, this ceiling drops to 1 %.
“The ALD system does not exist, but there is in fact much greater protection,” notes the researcher, who also mentions that “households can benefit from tax relief for exceptional health expenses remaining at their expense”.
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It remains to be seen where this 5 % figure mentioned by François Bayrou comes from. Contacted on this subject, the Prime Minister’s office has not yet been followed up. For Zeynep or, it is possible that this figure is a biased interpretation of the percentage of patients with chronic diseases and benefiting from the exemption, as their expenses exceeded 1 % of their income. According to a study published in 2020 by the European Observatory of Systems and Health Policy (dependent on WHO), around 7.9 % of people affiliated with the German Social Security had exceeded this ceiling of 1 % in 2018, which is (a little) closer to the figure given by François Bayrou.
