A-Infos (en) France, UCL AL #374 - Healthcare policy: the government is gutting Social Security (ca, de, fr, it, pt, tr)[machine translation]

Taking advantage of the summer lull in activism, the Lecornu government 
has made announcements that continue the trend of dismantling Social 
Security and its founding principle of solidarity across professions and 
generations. Healthcare policies appear to be driven not by studies from 
competent institutional bodies-such as the Social Security 
Directorate-but rather by plutocratic ideologies. --- Introduced in 2004 
and 2008 respectively, the flat-rate healthcare co-payment[1]and the 
medical deductible[2]will affect 13 million people in 2026-including 
those with chronic or long-term illnesses (ALD), recipients of permanent 
disability annuities due to occupational diseases or workplace 
accidents, disability pension holders, and retirees.

Reimbursements? De-reimbursements!
Furthermore, decrees issued on August 21 increase the *ticket 
modérateur*[3]-the portion of costs remaining after health insurance 
funds have made their reimbursement, which supplementary health 
insurance plans usually cover in full. This inevitably shifts an 
increasing share of expenses onto mutual insurers and private insurance 
companies. These organizations-which already failed to honor the premium 
freeze mandated by Article 13 of the 2026 Social Security Financing 
Act-will not hesitate to sharply raise their premiums. And this is 
happening at a time when 2.5 million people already lack supplementary 
health insurance.

Daily sickness allowances have long been in the crosshairs of successive 
governments. Now, the focus has shifted to capping the duration of 
prescriptions and extending the waiting period before benefits kick in. 
Indeed, work stoppages account for approximately 10% of the total budget 
of the health insurance branch. Yet, nearly a quarter of these are 
caused by workplace accidents or occupational diseases[4]. Adjusting the 
net minimum wage (SMIC) to keep pace with inflation is another factor 
driving up the cost of daily sickness allowances. Since wages below 1.5 
times the minimum wage are exempt from social security 
contributions-effectively allowing employers to avoid paying the 
socialized portion of these wages-this shortfall in the Social Security 
budget must be recouped elsewhere.

On July 22, the Prime Minister called for an "effort" from those who 
purchase more than 50 boxes of medication per year or visit the doctor 
more than 25 times. This new idea-pulled out of a hat without supporting 
data-would once again affect people suffering from chronic or severe 
illnesses (classified as *ALD* or long-term conditions). It would also 
impact people with disabilities-the very people for whom the government 
has already voted to freeze the disability allowance (AAH) in 2026. 
These are individuals facing a lack of recognition regarding their 
disabilities-a situation not improved by the recent reform of the 
departmental disability centers (MDPH).

This pattern of making an announcement only to later abandon it creates 
additional anxiety for people who already face an uncertain future in an 
ableist society that refuses to guarantee the material conditions for a 
free and dignified life for all. Sadly, adapting our environment to meet 
our vital needs is not considered part of health prevention. 
Anti-ableist organizations are sounding the alarm about barriers to 
healthcare access, insufficient resources, ill-suited systems, and the 
growing precariousness of these populations. Indeed, health policies 
themselves are a factor contributing to the disablement of individuals. 
Neoliberal propaganda aimed at dismantling Social Security
Following the late-July announcement that medical co-payments would be 
doubled, the government stated that the move "was not understood and may 
have appeared harsh." In recent years, it has become common practice for 
successive governments to make a harsh announcement, only to backtrack 
later and propose a reform that seems more "realistic" by comparison. 
Health Minister Stéphanie Rist told *Le Figaro* as early as August 20: 
"We have clarified the situation, and we are now working on a fair 
reform based on indexation to inflation since 2005[...]Consequently, the 
increase will be significantly lower than originally envisaged." These 
announcements run counter to the very principle of Social Security-a 
principle that actually calls for the abolition of co-payments and 
patient cost-sharing!

Demonstration in defense of Social Security, Paris, October 16, 2014.

Credits: Photothèque du mouvement social/Romani
The government dismisses the impact of working conditions on health. 
Occupational health services are under-resourced; all that remains are 
the statistics. Amidst the crisis of capitalism, work paces have 
intensified and workplace accidents have increased[5]. In this drive to 
maximize profit, work-related illnesses and disabilities are becoming 
more frequent, yet efforts are still made to cut costs at the expense of 
people who are already exploited and living in precarious conditions.

Capitalist propaganda speaks of "burdens" and has made us forget that 
social security contributions are actually part of our wages-a form of 
deferred, collective pay that covers, among other things, our healthcare 
needs. This is why exemptions from these contributions do not alarm the 
general public. The same applies to the Social Security annual 
ceiling-the mechanism that caps contributions on high salaries. Yet, all 
these measures represent lost revenue for the Social Security budget and 
are thus factors widening the so-called "Social Security deficit."

The myth of fraud
Framing "insufficient revenue" as a result of "social security fraud" is 
another propaganda tool widely echoed by the media. However, this 
narrative is not backed by statistical data. Allegations of fraud remain 
purely hypothetical, whereas fraud by healthcare professionals (in 
private facilities and private practice) has been extensively documented 
for some twenty years.

Furthermore, while the principle of Social Security solidarity was 
intended to guarantee universal healthcare benefits, the introduction of 
social safety-net allowances[6]has stigmatized the recipients of such 
benefits. The lack of a legal framework to prevent employers from 
creating precarious jobs serves to brand precarious workers as mere 
"welfare dependents." It is more necessary than ever to reclaim Social 
Security and extend it to all areas of life, in order to make it what it 
should never have ceased to be: a tool for the struggle against capitalism.

The UCL Social Security Working Group

Confirm

[1]A fixed amount deducted from the cost of all consultations or 
procedures performed by a doctor, as well as from radiological 
examinations and medical laboratory tests.

[2]An amount deducted from reimbursements for medication, paramedical 
services, and medical transport.

[3]Applies to medications with low or moderate "Medical Service 
Rendered" (SMR) ratings, medical devices, dental care, and medical 
transport.

[4]"Sick leave: beyond the effects of the health crisis, an acceleration 
since 2019," Drees, December 13, 2024.

[5]Ibid.

[6]Law of July 30, 1956.

https://www.unioncommunistelibertaire.org/?Politique-de-sante-le-gouvernement-massacre-la-Secu
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