Health insurance – Haro on complementary – News

Too expensive, inefficient, redundant with health insurance: in its (Very) black book of mutualsDaniel Rosenweg makes a severe diagnosis of the role and cost of supplementary health insurance.

The health insurance bill continues to increase for households. We are well placed to know: the UFC-Que Choisir scrutinizes calls for contributions from complementary health insurance each year. In his (Very) black book of mutualsDaniel Rosenweg, long-time journalist at Parisian and specialist in health economics, shares our observation. And adds a hell of a ladle. His analysis is scathing. For him, the constant increase in tariffs in recent years is indefensible : the Covid tax imposed by the State, put forward as a pretext, does not cover, far from it, the substantial savings made by complementary health insurance throughout the health crisis. And the price and reimbursement ceilings introduced on the occasion of 100% health moderate their costs on the items that traditionally fall to them…

Many inequalities

Inflation, notes the author, does not affect all households in the same way: the beneficiaries of collective company contracts are better protected from increases, while those who have no choice but to hedge individually are fully exposed. Between civil servants, retired, unemployed or self-employed persons, 30 million people are concerned! Even though reimbursements are less favorable to them… This is one of the inequalities generated by complementary insurance, but not the only one: 11 million people are not covered or need state aid to do so. .

In total, calculated Daniel Rosenweg, the complementary collected in 2019 38.4 billion euros per year, and only donated 30.3 billion in the form of services. This did not prevent them from raising their prices. Here again, individual contracts show the lowest redistribution rates: the benefits sometimes do not represent more than 60% of the contributions paid.

Management fees and acquisition fees

Where do the 8 billion difference go, if they are not used to moderate the contributions? Management costs, which double those of health insurance, and acquisition costs, that is to say advertising: the contracts are all alike, we must distinguish ourselves, even artificially. More surprisingly, the surpluses also finance investments in prestigious vineyards and media sporting events.

Fortunately, today, mutual insurance customers are less deprived than before. Termination at any time, after one year of membership, is a considerable asset to get rid of a contract whose price increases too sharply at each expiry date. The mandatory publication of the redistribution rate, ie the share of contributions paid back in the form of benefits, is also valuable for choosing your new contract. It is not always respected.

“Grand Secu”

Beyond these selection aids, Daniel Rosenweg pleads for a total overhaul of the healthcare financing system. Regretting the historical choice to promote the development of complementary, rather than increasing contributions so that health insurance is able to better finance care, he points to the system in force in Alsace-Moselle: a system of compulsory health insurance, more protective than our classic coverage. Its redistribution rate is 99%. In 2020, the accounts were in surplus. The position of the author is in tune with the times: a “big Social Security” is one of the avenues explored by the High Council for the Future of Health Insurance (HCAAM), commissioned by the government, whose conclusions will be made public in a few weeks.

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