The OGBL is not satisfied!

The traditional spring quadripartite meeting was held on June 7, 2023. As in previous years, the financial situation of maternity health insurance and the improvement of dental benefits were discussed, but no significant progress was made.

Maternity Health Insurance financial situation

The first item on the agenda was an analysis of the financial situation of the Maternity Health Insurance Scheme. The balance sheet for 2022 shows an operating loss of 41.6 million euros.

Revenues of around 3,910.3 million euros are not enough to fully offset the increase in expenditures to 3,951.9 million euros in 2022.

The total reserve therefore falls from 903.2 million euros in 2021 (24.9% of current expenditure) to 861.6 million euros in 2022 (21.8% of current expenditure). However, the reserve is still more than twice the 10% minimum required by the Social Security Code. There is therefore no cause for concern.

For the fiscal year 2023, the latest estimates point to a deficit of around 41.5 million euros for current operations. As a result, the total reserve will continue to decrease to 820.2 million euros, or 19.1% of the estimated current expenditure for 2023.

During the presentation of the financial situation of the Maternity Health Insurance Fund, the OGBL insisted that efforts to restore the financial equilibrium of the health insurance fund should not be made at the expense of policyholders. The OGBL also insisted that the announced new benefits, which have been promised for years, should finally be implemented.

The Minister of Social Security assured us that the current financial situation would not affect the implementation of the planned new benefits.

The OGBL also pointed out that the government would have to take over the cash benefits for the maternity component – benefits that were transferred to the health insurance system in the 2010 reform. If the government were to take over this cost, it would more than offset the aforementioned deficit.

Improving dental benefits

Another item discussed at the meeting was new dental benefits. In 2017, it was decided to allocate 12.4 million euros for new dental benefits.

At the last quadripartite meeting on October 19, 2022, there had been lengthy discussions about including procedures such as fissure filling, filling materials, and cavity preparation (“wäisse Plomb”) in the nomenclature. No progress was made on this last point. The OGBL cannot help but feel that the Association of Doctors and Dentists (Association des médecins et médecins-dentistes – AMMD) is not really committed to finding a solution to this problem in the interest of the patient.

The OGBL also asked the Minister of Social Security when insured persons would finally be able to benefit from the Direct Integral Payment (paiement intégral direct – PID) scheme, which will provide financial relief to insured persons, enabling them to avoid having to pay money in advance for medical care. If the minister is to be believed, the scheme should be in place by September 2023.

Carlos Pereira, Member of the Executive Board