Health carpooling, this source of savings which arouses the ire of patients and taxis

Severely criticized by taxis, the government's health carpooling project should soon see the light of day. The decree is currently in consultation, and could be published in the coming months, the office of the Minister of Health Frédéric Valletoux is informed. The measure appears in the Social Security financing bill (PLFSS) 2024 passed last December, and intends to encourage the sharing of journeys for medical patients by ambulance or taxi.

Concretely, without a valid medical reason to refuse carpooling, patients will no longer have the right to third-party payment and will therefore have to advance the costs. They will then only be reimbursed by Health Insurance on the basis of the shared transport fare. From 2025 a penalty would also apply. If Franceinfo gave some details on the draft decree, a source close to the matter believes that “a lot of fake news” has been relayed. “Shared transport excludes all emergency cases, and it is the doctor who chooses whether there is shared transport or not,” we refocus on the side of Frédéric Valletoux’s entourage. Thus, patients undergoing dialysis or chemotherapy will not be affected, for example, the government tries to reassure.

And “nothing has been decided on the mileage, it will come out of the consultation”, we add from the same source. A response to the Franceinfo article, which mentions a detour of 10 kilometers possible per passenger of an ambulance or a medical taxi, within the limit of a total detour of 30 kilometers. The threshold of 30 kilometers “appears well in the project, but is not necessarily what will be retained”, the Ministry of Health is told.

Whatever happens, there will “necessarily” be a deterioration of service for patients, regretted on Franceinfo Alain Olympie, representative of AP-HP users at Saint-Antoine hospital in Paris. Patient associations are indeed concerned about the impact of these changes, particularly for patients who must be treated by dialysis or chemotherapy.

The Renaloo association, which represents patients affected by kidney disease, dialysis or transplant recipients, wrote to the ministry and Health Insurance to demand that “neither the waiting times nor the delays linked to this new transport organization may lead to a deterioration in the quality, continuity and duration of care. She wants travel and waiting times to also be taken into account. Another concern of patient representatives: no obligation to wear a mask and barrier gestures is planned.

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For the government, looking for billions in budget savings, medical transport represents a significant windfall. “The expenses are in the billions,” confirms a source close to the matter. More precisely 5.5 billion euros in 2022, according to Health Insurance, up 7.2% in one year, under the effect of price increases and the rise in fuel prices.

In the PLFSS 2024, the government thus highlights the objective of “controlling health insurance expenses”. “The cost of shared transport is in fact 15 to 35% lower per trip, depending on the number of patients transported concurrently,” it is mentioned in the text. While only 15% of journeys are shared today, the objective is to reduce the cost of journeys for Social Security by 100 million euros per year between 2025 and 2027.

In article 30 of the PLFSS 2024, which concerns medical transport, the executive also points to two other objectives: “improving the response to transport needs” and “reducing the ecological footprint of this sector of an activity which today totals 65 million journeys per year for taxis and light medical vehicles (VSL) alone. These arguments do not convince taxis, who point out the potential shortfall: in rural areas, medical transport represents up to 90% of professionals' turnover, according to the Federation of Taxi Craftsmen.