Health insurance deficit will be higher than expected in 2024, according to Cnam director

"The deficit in the health branch will probably be higher than the 11,4 billion euros expected by the Social Security accounts commission in June" and "should remain at a historically very high level," declared Thomas Fatôme.

In his eyes, it is "a subject of major concern which the next government and Parliament will have to address quickly".

As head of health insurance, Thomas Fatôme has expressed concern about "ensuring that resources are used well and reacting when there are more dynamic expenses, such as those related to compensation for work stoppages", which will increase "by more than a billion" euros in 2024.

On this subject, the institution intends to "act on several fronts" until December.

The Cnam will "contact all insured persons who have been off work for more than eighteen months to (...) see if their leave is justified, see if there is a return to work initiated and possibly discuss the implementation of therapeutic part-time work", as well as "7.000 general practitioners who prescribe significant amounts of leave to discuss their practices and see if there is a way to better control the situation".

"New, more secure work stoppage certificates" will also be deployed.

Beyond that, Thomas Fatôme considers that "we need to think about a new system of compensation for sick leave that is more financially sustainable but also fairer", and that "the State and social partners should come back to the table on this subject by involving doctors, and Health Insurance will play its part".

"Is it normal that today an employee is less well covered because he does not have six months of seniority? Is it normal that the waiting days are mostly covered for employees in large companies but not in small ones?" he asked.

On a review of the coverage of care for chronic diseases, recommended by a recent report, "the system of 100% coverage of care for chronic pathologies is a pillar of health insurance, the heart of the reactor", assured its general director.

But "we are going to strengthen our actions so that doctors can clearly distinguish between care that should be covered 100% under long-term conditions and the others," he said.

Earlier screening, new prerogatives for certain paramedics, control of prescriptions, fight against fraud: the Cnam delivered 30 proposals to save 1,56 billion euros in 2025, in a report consulted by AFP in mid-July.