“Medicate” EHPADs, less take care of cancers in remission … which recommends health insurance to avoid digging its deficit

In order to avoid a deficit which could be at 41 billion euros in 2030, health insurance presented to the press, Tuesday, June 24, 2025, 60 proposals in its report “charges and products”, submitted each year to the government and to parliament upstream of the discussion of the bill of social security financing (PLFSS). Consequently, The final version will be published after the vote of the Council of the National Health Insurance Fund (CNAM). Consequently, on July 3.

“Without a major inflection. Therefore, the health insurance deficit, estimated at 16 billion euros for 2025, could widen even more by 2030,” said this document first. Meanwhile, The causes are known. Moreover, between “double effect of the aging of the population and the increase in chronic pathologies”, with health expenses supported by health insurance of 7,700 euros per year on average between 80 and 89 “medicate” ehpads, less take care years.

“We are at a rocking point. ” warns Thomas Fatôme, director general of the CNAM, who, paradoxically, presented a “report that wants to be and is optimistic”.

1 Change lifestyle habits – "medicate" ehpads, less take care

“Prevention” is one of the levers to activate: changes of life of life – in terms of tobacco. alcohol consumption – can thus influence 40 % of cancers.

More generally. personalized prevention would activate on the “my health space” platform, by mobilizing all the personal data listed by health insurance with the agreement of the insured.

2 “Prohibit fee overruns” for screening

This report also proposes to “prohibit fees overruns” for acts “in connection with organized screenings (mammography. ultrasound and colonoscopy …)”.

3 “Medicizing” the nursing homes

It is also suggested to “medicalize” the EHPAD. while 32 % of residents experience an emergency room and only half of them are then hospitalized.

There is no disengagement either closely or far from health insurance.

4 “medicate” ehpads, less take care Take out the ALD’s “remission phase” of the ALD

Some advanced measures may be debated. such as thinking about an exit from the ALD system (long -term condition, 100 % care of expenses related to this care and treatments) for “persons in a healing or remission of certain pathologies”, such as “cancers in the remission phase”.

“There is no disengagement either closely or far from health insurance,” defended Thomas Fatôme. “In the event of a relapse, for example, the device will be triggered again”.

This idea. which is not new, makes France Assos Health jump, the voice of users of the health system, which denounces a “dismantling of the quality of care for the benefit of unjust and counterproductive economies”.

The report also recommends “no longer allow 100 % support for services. health products, the efficiency of which does not justify such a level of reimbursement – or which do not have a link “medicate” ehpads, less take care with an ALD, for example thermal cures”.

5 A bonus-malus for the prevention of absenteeism

Finally. Thomas Fatôme recalled that “the dynamics of work stoppages is not sustainable” for health insurance. “Does that in any given time. it is up to health insurance to take care of a person who is in conflict with their employer when it is not linked to a medical reason? Asked in Echo Marguerite Cazeneuve, director delegated to the management and organization of CNAM care.

Companies that “have invested in the prevention of absenteeism. especially in the short term – well -being at work, adaptation of the position, etc. – We would give them a bonus and therefore we also think about a penalty system, “developed Thomas Fatôme.

Finally. the report would like to “integrate into the notice of work stoppage, the list of reasons for stopping and associated durations”.