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Prescription fees and sick notes: What's in France's 2024 budget?

The Local France
The Local France - [email protected]
Prescription fees and sick notes: What's in France's 2024 budget?
A doctor's office in central France. (Photo by JEFF PACHOUD / AFP)

France's 2024 budget - billed as an austerity budget - is currently being debated. Here's what the social security part of the budget means for medical fees, prescriptions and elderly care.

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It’s billed as an austerity social security budget - with some degree of good reason. France’s social security deficit is expected to rise from €8.8 billion in 2023 to €11.2 billion in 2024, more than had been previously forecast, and the government is looking for savings of €3.5 billion.

The 2024 budget is split up into several sections - here's what the social security section of the bill will mean for everyday acts like going to the doctor.

Increased charges

Out-of-pocket fees - known as the franchise médicale - paid by patients for prescriptions and some treatments is expected to increase, as the government looks for savings of €1.2 billion from France’s social security bill in 2024 by cutting unnecessary or excess prescriptions.

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This refers to the part of the cost that is not reimbursed by the carte vitale.

Exact details of which prescriptions/treatments are yet to be revealed.

Sick notes

The bill includes plans to limit the time that patients can stay off work using a single sick note prescribed via téléconsultation (an online medical appointment) to three days. 

It would not affect a sick note provided by a doctor at an in-person appointment, but it’s part of a wider plan to limit working time lost to illness, which includes a crackdown on arrêts maladie (sick notes). Plans include increased monitoring of sick note use, and allowing officials and employers to confirm their legitimacy.

READ ALSO ‘Arrêt de maladie’: Why you'll need a sick note in France - and how to get one

Under the plans, employers can assign an approved doctor to evaluate the employee, and suspend statutory sick pay, if the doctor believes the sick note is unnecessary. 

The government said it is planning to reform statutory sick pay in the next few months.

Preventative health

Prevention appointments at key stages of life were created by the Social Security budget in 2023. Everyone registered in the French health system must be offered three free medical visits by Assurance maladie at ages 25, 45 and 65. The objective is to strengthen adult health and prevent avoidable chronic diseases, by raising awareness of lifestyle risks. 

Measures in the bill indicate that health professionals cannot hike their fees to the State for these appointments.

Single-dose drugs

In case of drug shortages, pharmacies may be required to dispense some drugs on a ‘pill by pill’ basis, to ensure supplies are stretched as far as possible and that patients receive the precise dose prescribed by a doctor - rather than simply doling out a pre-prepared pack.

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Some patients may also be required to take a test to ensure prescribed antibiotics are appropriate for their condition. The intention is to reduce drug shortages and the risk of antibiotic resistance.

Antibiotics

The bill proposes that pharmacists should be authorised to dispense antibiotics without prescription for cases of tonsillitis (strep throat) and cystitis, after a test has been carried out to confirm the bacterial origin of the illness.

Patients suffering from a sore throat or a burning sensation when they urinate will be able to go to a pharmacy, take a test and get an antibiotic directly, without having to visit the doctor first.

Periods

Women aged 25 and under who are in receipt of complémentaire santé solidaire (CSS) medical insurance top-ups will have the cost of reusable period products, such as menstrual cups and period pants, reimbursed.

Condoms

The bill provides for the provision of free condoms from pharmacies for anyone aged 26 and under. This measure has been operational since January 2023.

Complementary health insurance access

Households in receipt of social benefits are entitled to complementary health insurance (CSS) for free or at a heavy discount. But, to date, many entitled households do not take up the scheme. Under the new budget, discounted CSS will be automatically offered for households in receipt of the following benefits:

  • Allocation aux adultes handicapés (AAH) ;
  • Allocation supplémentaire d’invalidité (ASI) ;
  • Allocation de solidarité spécifique (ASS) ;
  • Allocation du contrat d’engagement jeune (ACEJ).

Elderly care

Additional resources will be allocated for the creation of new home nursing service places for the elderly, as well as funding for an increase in the number of professionals working in residential homes.

Child support

The bill proposes that a service is set up for all children under the age of 6 with a disabilities or suspected disabilities, creating a pathway for assessment, diagnosis and intervention.

The service will support families with children affected by :

  • neurodevelopmental disorders;
  • cerebral palsy;
  • polyhandicap;
  • sensory disabilities.

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