After the great demonstration of 19 March, which brought together more than 40,000 professionals opposed to the Health Act, the Prime Minister chose a large national health conference, extensive consultation supposed to unite all physicians. Private doctors then emphasize the strangeness of the method is to consult the profession after spending a force widely disputed law. Worse November 13 while doctors began a movement on a scale never equaled over 80% of offices closed and they prepare a health blockade to protest against the law, they choose to cease movement at night to 13 will make available a traumatized country. The government's response was scathing. While the Liberals propose to participate in the consultation in exchange for a suspension of the law, the government chose to push through the law by voting in a period of mourning, omitting the way to greet the sense of responsibility of private doctors who had to stop blocking their health movement.
Manuel Valls makes pass this law shows no signs of appeasement, and now claims to consult the profession on the future of our health system. The unions of liberal doctors refuse to participate in this coarse farce and organize the same day national conference they prepare for 2 months and go there to announce their proposals. The Federation of Physicians of France (FMF), contrary to statements by Marisol Touraine, Minister of Health, has proposed solutions for the system to be reformed. These solutions are far from timid and corporatist but require a courage that is singularly lacking in this government.
Reforms
The reform of the health system must: define the role of each in the city and the hospital; define the patient's course of care; generate margins of economies; change studies to publicize to students during their university studies, liberal medicine. City physicians must have the means to avoid unnecessary hospitalizations and welcome early hospital discharges with the development of ambulatory medicine. The hospital must have the means to welcome all genuine emergencies and ways of hospitalization, but must stop outsourcing and must communicate in real time with the city, only way to ensure genuine coordination of care. The hospital must have the means to ensure hospitalizations but no longer has to outsource.
The two key measures that are likely to radically change mentalities would be the abolition of the home hospitalization and the removal of Samu in large urban areas within 20 minutes of an emergency service worthy of the name. In the aftermath of 13 November 2015, where emergency services have been particularly effective this proposal can detonate; but if we look more closely, the UAS behaved that day like most industrialized and immediately transported the injured to hospital countries thus saving many lives.
Have the courage to change attitudes and stop thinking that virtue and quality are exclusively in the hospital. Let's make the hospital communicates with the city and develop secure messaging and forget the DMP shared medical records that already in 2004 deserved the nickname bad start record before 500 million later to still be stalled. Patients should be able to find a city in response to all unscheduled care that have nothing to do in the hospital and cluttering emergencies costing 3 billion to the community. Their access to the hospital will be in ambulance or mail from a private doctor.
Stop harassment of boxes!
Students should discover during their private medical university courses so that they are not afraid to move, provided that they do not discover a liberal medicine boxes made of harassment and finicky controls but medicine where the practitioner welcomes patients into proper premises, with secretarial and / or nurse. This reform is possible: it requires a massive investment in private practice, a Marshall Plan 5 billion in exchange for 100 000 non-relocatable jobs that would allow private doctors to work in the conditions of their European colleagues.
To release these 5 billion immediately, we must have the ambition to fill the gap and completely reorganize the health system. We must dare to impose on the National Fund of health insurance for salaried workers (CNAMTS) to cease to organize care by eliminating the chronic disease surveillance (SOPHIA). Must be removed, health centers that serve no purpose except to monitor patients repeatedly monitored remove health shops, and other health coaching. The Court of Auditors estimated 2 billion savings can run CNAMTS.
We must dare to require mutual and complementary 4.8 billion do not render annually to the French. We must dare to change the financing of hospital emergencies are that each time the director of the hospital receives € 250, again we could save 3 billion with a regulation of home emergency pathologies that have nothing to do there. We must dare to adjust the prices of drugs coming on the market with ASMR 5 (rendering service improvement lowest); we could easily recover 2 billion.
We must dare to change the generic reimbursement rules on the German model which charges the patient requiring the original price difference with the cheapest generic but instead fully reimburse the patient accepts the cheapest generic. These proposals are on the table of the Minister for over 3 years. This reform is possible, the deficit is not inevitable, the fall of the liberal demography is not irremediable. The will and the political courage lacking.
No comments:
Post a Comment