Against the backdrop of a new day of action by hospital health workers and emergency doctors, the Senate is due to adopt on Tuesday 11 June, after the National Assembly, the health bill put forward by Agnès Buzyn, after injecting it with several new measures such as the end of the "health care" system and the introduction of a new "health care" system. numerus Clausus...the development of community hospitals... In response, Deloitte analyzed the expectations of the French people with regard to the current health system and the main reforms of the health plan. The results.
Dor more than two months now, there has been a nationwide movement that has not wavered: health care staff and emergency doctors in French hospitals have been calling for an increase in salaries and staffing levels, and want to fight against the closure of maternity wards, clinics and certain unprofitable hospital services, thus creating serious dysfunctions in access to care for all and worrying medical deserts. According to the Inter-Urgency Collective, the staff are "exhausted by their working conditions" and are at the forefront of this social conflict, which ensures that 95 emergency services are concerned. And the figures speak for themselves: the number of patients cared for in emergency departments has risen from 10 million in 1996 to 21 million in 2016. The staff is overstretched due to a lack of financial resources and personnel. The demands are for 10,000 additional nursing posts and care assistants, the reopening of "downstream beds" and a bonus of 300 euros per month.
The mobilization of nurses' aides, doctors and emergency doctors is supported by all the health federations of the CGT, FO, Sud, CFE-CGC intersyndicale.
As Agnès Buzin's health bill is voted today, the Deloitte health barometer shows a very strong attachment of the French to their health system with a growing concern about local care and medical deserts. Indeed, to whom will patients turn when there are no more staff?
High expectations of accessibility to care
French people's satisfaction with their health care system, which had tended to deteriorate since 2016, is improving this year. 81% of the French people say they are satisfied with the quality of care, 80% with the safety of care and 75% with the education of healthcare personnel.
While the accessibility of care is improving overall (60% of the French are satisfied), the majority of rural residents remain dissatisfied with the issue of geographical proximity (54% dissatisfied compared to only 28% in the Paris urban area).
"One of the major points of the bill on health provides for the establishment of local hospitals and thus responds to a growing concern among the French". points out Michel Sebbane, Public Sector Health and Social Consulting Partner at Deloitte.
Nevertheless, these local hospitals will not include maternity hospitals, even though, according to the barometer, it is precisely these maternity hospitals that the French want to be very close to their homes, even favouring, for 62% of them, proximity at the level of specialization.
They are also very much in favour of the development of group practice (39%), a solution put forward by the bill, to combat medical deserts, before the numerus clausus (27%) and the creation of medical assistants (22%). The inhabitants living in rural areas are in favour of the development of these centres at 43%.
The human being at the heart of the health journey
While the bill provides for the development of telehealth, the barometer underlines the attachment of the French to their practitioner.
As a proof, the attending physician is considered by 66% of the interviewees as the most legitimate actor in terms of prevention or health education, digital actors such as Google, Apple, Amazon, Microsoft... gathering only 2% of the interviewees.
The general practitioner is also at the top of the top 3 health players enjoying the confidence of the French people. 88% of the respondents would be willing to make their personal health data accessible to their general practitioner; next we find the specialist doctor, and finally the hospital. The web players, says GAFAM, are in last position with only 6% of respondents ready to transmit their personal health information.
Furthermore, digital tools are progressing in their use, with only 23% not using any digital health tool (-8 points compared to 2018). 43% of the French thus use the online delivery of analysis results (+5 points compared to 2018), 39% use online appointment scheduling tools (+7 points) and 25% use the shared medical file, the generalisation of which was launched at the end of 2018 (+14 points).
On the other hand, connected objects are struggling to make a place for themselves in French practices since only 12% of them say they use them. The use of connected objects in the home is still not very widespread (10%) and people who are equipped or planning to be equipped expect real-time assistance (43%), as well as improved health and quality of life (35%).
While the development of telehealth advocated by the bill is far from unanimous, 68% of those interviewed nevertheless say they are ready to consult a physician using artificial intelligence tools to assist in diagnosis. 52% are ready to entrust their health to AI tools for the interpretation of medical analyses (blood test, urine analysis, etc.) for example.
However, the French are hesitant about remote consultations and are not prepared to do without human contact. For a standard consultation, 43% of respondents prefer a teleconsultation with the presence of a doctor (compared to only 9% of the French who choose the web format without human presence or interaction).
This can vary by a few points depending on the type of consultation. For example, for a prescription refill, only 31% of respondents prefer teleconsultation with the presence of a doctor (-12 points compared to a standard consultation), and the web format gains 3 points, 6% say they prefer the web format without human interaction.
The reform of 100% health, a challenge for mutuals
91% of the French are holders of a complementary health insurance contract. Although the majority of them are satisfied with the reimbursements they receive, the 100% health reform (zero remains payable for optical, dental and hearing care), makes them fear, for 58% of them, an increase in contributions and for 30%, a deterioration in the quality of services. They plan to maintain their health consumption habits rather than changing them to fit into the standard basket. For 67%, they intend to maintain their consumption habits for dental care and 66% for optical care. Among those who anticipate an increase in their contribution with the 100% health reform, 65% would not, however, be prepared to pay more. The others put at 29.8€ the average amount they would be ready to pay more annually.
" Supplementary health insurance companies will have to adjust their offer beyond the base defined in the framework of the "100% santé" reform, in order to offer coverage that takes into account current consumption practices in terms of optical and dental care. They are also expected in the field of services related to dependency". says Jean-François Poletti, Insurance Consulting Partner at Deloitte.
The barometer also highlights a strong expectation: to be able to benefit from services such as home support (26%), massage or meditation (26%) or alternative medicine (21%). While the majority of them are willing to pay for connected objects (58%), well-being (57%) and sport (56%) and even more for home help (56%), a majority of French people are not willing to do the same for medical services they consider more basic and essential: health transport, care network, hospitalisation.
Regarding digital health services, 44% would prefer to pay for them on a pay-per-use basis, while only 3 out of 10 French people would opt instead for a service included in their overall subscription in return for an increase in contribution.
The debate on the treatment of homeopathy remains open.
The Minister of Health assured, in an interview with Libération, that one of the objectives of her bill was to improve "the reception in town before emergencies". Indeed, there is an emergency ...
Deputies and senators will therefore try to agree on a common version, in a joint joint committee meeting scheduled for 20 June.
Methodology
The study "Les Français et la santé" was carried out on a sample of 2003 people, representative of the French population aged 18 and over, constituted according to the quota method, with regard to the criteria of gender, age, socio-professional category, category of urban area and region of residence. Interviews were conducted using a self-administered online questionnaire. The interviews were conducted from 19 April to 2 May 2019.
Header image : René Laennec using his first stethoscope
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