a solution to the decline in health care reimbursements

Dental or optical care, medical consultations with a specialist, including a general practitioner, the purchase of medicines … more and more French people are giving up on treatment for economic reasons: six out of ten, according to an Opinionway survey carried out in 2019. Ile-de-France region has just entered into a triple partnership with three health insurers to create a regional mutual fund
from which all residents of Ile-de-France will be able to benefit from 1 February 2023.

Pontault Combault
, Montreuil
, Haÿ-les-Roses
, Puteaux
, The Kremlin-Bicêtre
, Fontenay-sous-Bois
… even cities are concerned about this and more and more of them are offering mutual funds to their constituents. Bobigny
(Seine-Saint-Denis) will join this non-exhaustive list by the end of the year. It was an election promise from the new Communist Mayor Abdel Sadi who, at the beginning of the year, launched an important consultation with the inhabitants to find out the needs for health coverage. The time has come to choose the partner insurer who will offer a community and joint mutual fund. The terms are not chosen at random and the mayor has entrusted the implementation of the project not to the deputy to health but to solidarity.

In the course of the investigations carried out upstream, the municipality made this sad observation: “One in two families has no mutual insurance” reveals Mohamad Aïssani, municipal councilor delegated to the Maison des solidarités. First obstacle observed: the price. “Two-thirds of the people who responded are single-parent families led by a woman who finds herself without mutual insurance. And it is not even glasses or dental care that are at the forefront of renunciations, but daily health care, such as visits to the GP, the purchase of medicines or even hospitalization “.

Bobigny’s future common partner will have to be established in the city and accessible to the population, “By staying in dedicated places with physically present interlocutors, to be closer to the inhabitants. Because we are witnessing a digital divide: today everything is digitized, including access to healthcare, while some of our citizens do not have a computer or do not know how to use it “ says Mohamad Aissani. The mutual society selected by the Municipality will also identify the people who are entitled to CSS (complementary health care, former CMU, universal health coverage) and who are out of care “because they do not have access to their rights, they do not always know them and do not know how to access them. Our partner will act as a relay to give access to the CSS to those who can claim it”. Even in the Kremlin-Bicêtre (Val-de-Marne), where residents have been able to benefit from mutual insurance since September 2021, the presence of the insurer in the city was a non-negotiable condition. The mutual society then organizes weekly sessions at the town hall. “It has already received two hundred people and one hundred registrations have been registered; they cover 180 people” welcomes MRC Mayor Jean-Luc Laurent who adds that most of them are over 66 and so on “20% of new members were not previously covered by a mutual. 80% had one and left because the municipal mutual was more attractive financially and in terms of health coverage.”

In Bobigny the municipal health insurance will be destined not only to the inhabitants and agents of the municipality but also to all those who work there: the more the city is able to bring a large clientele to the insurer, the more it can negotiate a reduction in prices. The proposed contributions should be 20 to 25% less than the market price according to the municipal councilor for solidarity who specifies: “There will be different formulas proposed but the health insurance will be the same for everyone, regardless of age. Among the questionnaires we received, I remember a case in which a 76-year-old single woman paid 150 euros a month, an enormous amount, because she had severe pathologies..

The communist municipality also specifies that the chosen mutual society will have to guarantee a controlled annual increase in its contributions: “It is inconceivable that it offers a basic formula at 25 euros a month, for example, and that it rises to 40 euros the following year. Our partner must share our values ​​of solidarity and mutual aid; this is why we are very attached to the mutual aid system. “ concludes Mohamad Aissani.

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