Public hospitals demand ‘significant’ price increases

Public hospitals hit by historic shortages are this Friday calling on the Executive to “significantly” increase hospitalization rates. They consider them “outdated”, in particular due to inflation, and are primarily aimed at full hospitalization and critical care.

With limited finances, government officials must soon make decisions about changing the level of hospitalizations covered by health insurance by 2024, as they do every year. Current prices “no longer correspond to the real costs of treatment” and “no longer allow to finance the real activities of hospitals,” regrets the French Hospital Federation (FHF, public hospitals).

“Starting from 2020, the evolution of prices does not allow us to cover the increase in the real costs of institutions, which can be explained by the evolution of the typology of patients treated and the dynamics of wage costs,” she believes, estimating that prices have fallen by “9–10% since 2020.”

The total deficit in 2023 will be 1.6 billion euros.

Apart from exceptional inflation, “useful measures to increase wages” (the Segura de la Santé measures, increased public services, increased night and weekend shifts) have only been partially offset, the FHF argues. “Even establishments with dynamic activities are experiencing a deterioration in their financial position”, and the total deficit of establishments “doubled between 2019 and 2022”, reaching 1.6 billion euros in 2023.

The executive branch should “support” in particular those specialties that treat severe and complex overnight cases, the FHF argues: full hospital medicine, major surgery, intensive care and resuscitation. The “urgency” is also to reduce the “public health debt.” From the start of the health crisis in 2020 until the end of 2023, “3.5 million medical and surgical hospitalizations were not carried out,” especially for “people over 80 years of age, including the number of hospitalizations remaining 8.9% lower than in 2019,” the federation reminds.

This 2024 price campaign has all the elements of an impossible equation. The executive branch must distribute the package between the public and private sectors, each of which requires an increase of about 10%. But the National Health Insurance (Ondam) spending target for the year, adopted with the social security budget in the autumn, allows us to hope for only a 3.2% increase, according to the Federation of Private Hospitals. The Economy Ministry has since revised its growth forecasts and announced new economic plans.