French Funds End 1993 Deal With Doctors

The French health funds have ended the 1993 framework medical agreement governing relations between the medical profession and the state. The funds had threatened to end it earlier, when they were faced by fierce opposition by some medical unions to health service reforms under the Juppe plan which would affect their practices.

Jean-Marie Spaeth, president of the main fund organization, the CNAM, said the tearing-up of the 1993 agreement would have no impact on reimbursement of patients. Separate deals rather than an all-in framework agreement would now have to be negotiated with 66,000 general practitioners and around 50,000 specialists.

He said there seemed to be a deep gulf between two doctors' organizations, the CSMF and the FMF, over spending limits, and after some 100 hours of discussion and four months of consultation there was no way the CNAM could translate the requirements into a new all-in deal. Another doctors' group, MG-France, which appears ready to do a deal with the government, has been calling for an end to the 1993 agreement for some time.