France's national union of independent radiologists (Fédération nationale de médecins radiologues, FNMR) has reacted strongly again to news that the National Assembly has voted to re-establish Article 52 bis of the draft bill for the 2017 social security budget (PLFSS 2017).
The measure gives total power to the directorate general of the national medical insurance fund for salaried workers (Caisse nationale d'assurance maladie des travailleurs salariés, CNAM-TS), for fixing the prices of CT, MRI, and PET, according to the FNMR. It had been removed by the Senate, only to be re-established by the deputies of the National Assembly on 5 December.
The draft bill was subject to a second reading on 28 November. This was followed by the deputies voting to re-establish the government-proposed amendment, Article 52 bis and enlarge its remit through two subamendments that included public health centers, private nonprofit, and private companies.
The objective of article 52 bis is to provide the CNAM-TS with unilateral power to reduce the budget for CT, MRI, PET, and PET/MRI, and this will have a negative impact on longer-term investment and patient welfare, according to FNMR.
"With this article, the CNAMTS can derogate from the system of conventions, in order to arbitrarily reduce the tariffs of technical acts which finance the acquisition and running of this equipment (staff salaries, premises, contrast agents, quality control, maintenance, after-sales service, and upgrades etc.)," the FNMR stated in a press release issued on 5 December.
The statement pointed to several consequences, including a lower capacity for private centers and hospitals to invest in the most up-to-date CT, MRI, PET, and PET/MRI machines, which would penalize patients through limiting their access to these techniques.
"The CNAMTS claims this article will make savings. In fact, it will result in lengthier waiting times for CT and MRI appointments, will worsen France's position in terms of cross-sectional imaging, and will hamper the development of outpatient management. Contrary to popular belief, it is recourse to CT or MRI, which will generate savings due to more accurate and faster diagnostics that will orient patients to suitable treatments in the shortest delay. For inpatients, rapid access to this imaging equipment also cuts spending through reducing length of hospital stay."
The statement reconfirmed FNMR's opposition to administrative authoritarian management and its total opposition to the implementation of an "exceptional measure" that went against recently signed medical conventions. The statement underlined the union's belief in the wisdom of the Constitutional Council, and requested that it remove the article from the draft law.
