At the beginning of October, a bolt from the blue: the management of the
National Health Insurance Fund (CNAM) announced plans to dismantle itsmedical service. 7,000 employees are affected and 60 million insured
persons see their medical confidentiality threatened. Pascale, an
employee of the service, tells us about the issues and the fight that is
beginning. ---- Can you explain what the medical service of the Health
Insurance is and its role? The basic activity is to give a medical
opinion on the benefits allocated to social security beneficiaries[1].
Then there is the support of health professionals, in particular public
health issues, such as the Tramadol issue[2]. Finally, the fight against
fraud on insured persons from certain health professionals. Dental and
ophthalmological health centers for example.
Why is the CNAM management deciding to eliminate this service today?
Thomas Fatome, director of the CNAM, has been talking a lot about the
problem of sick leave since September. He blames the medical service for
this management. The aim behind the elimination of the medical service
and its independence is to achieve administrative management of sick
leave. This project comes after the report of the General Inspectorate
of Social Affairs which pointed out difficulties at all levels within
the medical service. In addition to the unsuitable work tools, there is
the inconsistent management of the successive CNAM departments. And it
is also a question of making savings.
What consequences would this elimination have for users in terms of
medical care? Medical advisors and practitioner advisors are generally
independent from the CPAMs and their opinions are binding on the funds.
If the medical service becomes an entity dependent on the director of
the primary fund, there will be a risk of seeing a policy of numbers
emerge in terms of the allocation of benefits.
And the consequences for colleagues? What is the state of mind? The
project does not explicitly mention the future of the staff and their
status. It is a total dismantling in eighteen months that is announced.
We are ultimately being forced to change employers. Many feel
demotivated, worried and question the brutality of the announcement and
the vagueness of the project which is contained in ten pages to decide
the fate of 7,000 people. Some people are considering resigning or
looking for positions in other organizations.
The CNAM unions are all up in arms against this elimination, do you know
what follow-up is planned for the mobilization? Various actions are
underway: petition, letters to the Minister of Health, to professional
orders, to deputies because the Social Security Financing Act is
currently being debated in the National Assembly. A new strike too
because the strike of October 3 was massive: one in two employees on
average and rates of 80% in certain regions. Unprecedented!
Inter-union demonstration for a wage increase, Martin Noda / Hans Lucas,
Photothèque Rouge
This is the first time you have gone on strike, what motivated you? I
joined an independent medical service thirty years ago, that this
independence is doomed to disappear is not acceptable. Especially since
they want to dissolve us while the management, which is responsible, is
not worried.
Interview by Hugues (Fougères)
The fight of the medical service can be followed and supported on the
CGT CNAM website cgtcnam.fr.
Validate
[1]Such as exemptions from co-payments, work stoppages, management of
work accidents, admissions for disability and occupational diseases,
opinions on requests for prior agreement (for example in obesity surgery
or cosmetic surgery)
[2]"Health: Diane, 33, breaks the taboo on addiction to Tramadol",
francetvinfo.fr, June 7, 2024
https://www.unioncommunistelibertaire.org/?Luttes-salariales-Le-service-medical-de-la-CNAM-dans-le-collimateur
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