773 euros for the insured and a demiplafond for health professionals

Social security, it is decidedly the case of the President of the Republic. Defending the Bill reforming the hospital and is implementing regional health agencies, yesterday, in the Jura, Nicolas Sarkozy has created the surprise by announcing the introduction of "penalties floors" for hackers to Medicare (doctors, patients, facilities, employers) "on the model of the mechanism in place for combating illegal labour". For the black work, an employer who does not declare an employee must now fulfill the contributions calculated on a lump sum basis of 6 times the SMIC monthly (approximately 8,000 euros), absence of evidence to the contrary.

For Medicare, the current penalties for hackers range from 75 euros to 5.032 euros, harm. According to a preliminary article of the 2009 budget of the social security ("Les Echos" of September 9), floors of penalties would be imposed in cases of "established fraud": they may be less than 1/10 of the monthly ceiling of social security (2.773 euros for the insured) and a demi-plafond for health professionals.

Quickly record sector 2

Further evidence of voluntarism, Nicolas Sarkozy set cap the return to the balance of the Medicare "2011" (the 2008 deficit is expected to EUR 4.1 billion). However, this goal is less ambitious than it seems: the Prime Minister, François Fillon, announced the return to the balance of the whole of social security in 2011, a goal that seems unattainable today (the retirement industry will be widely deficit).

To restore the accounts, Nicolas Sarkozy again put pressure on physicians, who resumed negotiations with the CNAM next Thursday. They endorse the passage of the consultation from 22 to 23 euros for general practitioners. In Exchange, the Liberals must accept a regulation to better distribute the doctors in the territory. And the establishment of an area optional for an attempt to limit exceedances of sector 2 practitioners fees. For the President, the optional sector must be recorded "before the end of the year". Above all, "some form of adapted regulation could be considered" for physicians who decide to stay in sector 2. Employees unions are demanding a regulation of the rates of sector 2 for months, doctors the deny categorically, which blocks the discussions.

"Care packages"

"The Elysee resumes in hand health policy", reacts Michel Chassang, President of the Confederation of medical unions French, which is nevertheless pleased that Nicolas Sarkozy has not mentioned measures disadvantageous to improve medical demography, but only "best earnings" for those who settled in the sous-dotées areas. The President of the CSMF also welcomes the establishment of a convention between health insurance and hospital practitioners to better control requirements in the hospital. Nicolas Sarkozy also announced the experimentation of "care packages" (for hospitals, as liberal physicians) persons suffering from chronic diseases, to "substitute for payment to the Act.

The act reforming the Organization of health itself, the President of the Republic has maintained the cap, despite criticism ("Les Echos" of yesterday). He added to the specifications of the hospitals the obligation to make public "a few simple indicators such as mortality rates or the rates of infections".