Key Benefits:
The National Assembly and the Senate adopted,
Vu la Constitutional Council decision No. 2004-508 of 16 December 2004 ;
The President of the Republic enacts the following legislation:
It is approved the report annexed to this Law on Health and Social Policy Directions and the objectives that determine the general conditions of the financial balance of social security for the year 2005.
Article L. 132-3-2 of the Financial Courts Code is supplemented by a paragraph to read as follows:
"It establishes, in conjunction with the Regional Boards of Accounts, a three-year program of work to be carried out, including the comparative assessment of the costs and management of institutions funded by health insurance. This is reflected in the report referred to in LO 132-3. »
I. - After article L. 131-7 of the Social Security Code, an article L. 131-8 is inserted as follows:
"Art. L. 131-8. - The Government shall submit annually, by 1 October, a report to the competent committees of the assemblies on the conditions of application of Article L. 131-7.
“This report includes:
" - the various measures giving rise to compensation, divided by nature;
" - the various measures not giving rise to full compensation;
" - ventilation of compensation measures by branch and by compulsory basic regime;
" - the evolution of compensation measures over the last three fiscal years, the current fiscal year and the upcoming fiscal year;
" - the measures to implement the compensation principle envisaged for the coming year;
" - the amount of debts on the State held by social security agencies or by funds contributing to their financing under the provisions of Article L. 131-7. »
II. - In the same code, Article L. 131-7-1 becomes Article L. 131-9.
I. - Article L. 227-1 of the Social Security Code is amended as follows:
1° After the 2° of I, it is inserted a 2° bis as follows:
"2° bis The objectives of improving the productivity of the network and its territorial organization; »
2° The III is thus amended:
(a) In the first sentence, the words: "minimum three years" are replaced by the words: "minimum four years";
(b) It is supplemented by a sub-item:
"The conventions and, if any, the amendments to them shall be transmitted to the commission referred to in Article L. 111-9. »
II. - Before the last paragraph of Article L. 228-1 of the same code, it is inserted a paragraph as follows:
"The President of the Supervisory Board may apply for a general inspection of social affairs, in accordance with the Minister for Social Security, for a support mission as part of the preparatory work for the drafting of the notice referred to in the preceding paragraph. »
III. - Chapter V of Book I of the same code is supplemented by an article L. 115-8 as follows:
"Art. L. 115-8. - In accordance with the laws of financing social security, the competent authority of the State may conclude conventions with mutual commitments with national bodies under the provisions of articles L. 151-1 or L. 152-1. These conventions include the provisions of Article L. 227-1 corresponding to the missions of these organizations. »
Article L. 723-12 of the Rural Code is amended as follows:
1° In the second sentence of the first paragraph, the words "minimum of three years" are replaced by the words "minimum of four years";
2° After the second sentence of the second paragraph, two sentences are inserted:
"The convention is transmitted to Parliament. An assessment of its application, particularly in the light of the guidelines established by the Social Security Financing Acts, is also transmitted to it within three years of its signature. »
The Government will submit to Parliament, by 31 March 2005, a report on the situation and prospects of the fund established in Article L. 731-1 of the Rural Code.
[Dispositions declared not in conformity with the Constitution by decision of the Constitutional Council No. 2004-508 DC of 16 December 2004. ]
I. - The 9th of Article L. 651-1 of the Social Security Code is as follows:
« 9° The following organizations, not mentioned in 1° to 8°: establishments and undertakings carrying out the activity defined in Article L. 511-1 of the monetary and financial code and falling under chapters I to VII, as well as section 2 of Chapter VIII of Title I of Book V of the same code, insurance, capitalization and reinsurance companies of any nature governed by the code of mutual insurance, mutual funds and unions under Book II of the code "
II. - In the eighth paragraph of Article L. 651-3 of the same code, the words: "at 9°" are replaced by the word: "at" and the words: "20 of Act No. 84-46 of 24 January 1984 on the activity and control of credit institutions" are replaced by the words: "L. 511-30 of the monetary and financial code".
III. - In the fourth paragraph of Article L. 651-5 of the same code, the words: "general exploitation, resulting from" are replaced by the words: "of result, consistent with".
IV. - After the fourth paragraph of the same article, three subparagraphs are inserted:
"For mutual trusts and mutual unions under Book II of the Code of Mutuality, institutions of foresight and unions of institutions of foresight under Title III of Book IX of this Code and institutions of foresight under Chapter II, Part II, of the Rural Code, the contribution of social solidarity shall be constituted, for their main activity, by the contributions, retrofits and acceptances of the
"For the debtors referred to in the two preceding paragraphs, are not included in the turnover selected to establish the contribution or the contributions, premiums and acceptances from exempt contracts of the tax on insurance agreements pursuant to 15° and 16° of section 995 of the General Tax Code, or the discounts paid to them as part of their participation in the management of a legal health insurance plan.
"For the debtors referred to in the fifth paragraph, are not included in the turnover to establish the contribution of the grants granted by the fund under section L. 421-1 of the mutuality code. »
V. The provisions of this article shall enter into force for the contribution due on 1 January 2005.
After Article L. 256-4 of the Social Security Code, an article L. 256-5 is inserted as follows:
"Art. L. 256-5. - Social security organizations may, for the recovery of unduly paid amounts, initiate a recovery action under the conditions set out in the sixth to eighth paragraphs of Article L. 133-4. »
After article L. 725-3 of the rural code, an article L. 725-3-1 is inserted as follows:
"Art. L. 725-3-1. - Organizations of agricultural social mutuality may, for the recovery of unduly paid sums, initiate recovery action under the conditions set out in the sixth to eighth paragraphs of Article L. 133-4 of the Social Security Code. »
[Dispositions declared not in conformity with the Constitution by decision of the Constitutional Council No. 2004-508 DC of 16 December 2004. ]
I. - The second paragraph (1°) of Article 13 of Law No. 2004-626 of 30 June 2004 on solidarity for the autonomy of older persons and persons with disabilities is supplemented by the words: "48 % of the products of this section are allocated to the financing, by the basic compulsory health insurance schemes, of the establishments and services mentioned in the 6th of the I of Article L. 312-1 of the Code of Social Action and of the 2111 "
II. - The third paragraph (2°) of the same article is supplemented by the words: " 15% of the products of this section are allocated to financing by the mandatory basic health insurance schemes of the establishments and services mentioned in 2°, 3°, 7° and 11° of the I of Article L. 312-1 of the Code of Social Action and Families in 2005; "
I. - In the seventh paragraph (1°) of Article L. 241-2 of the Social Security Code, the rate "21.42 %" is replaced by the rate "32.50 %".
II. - The provisions of this section apply to amounts payable as of January 1, 2005.
For 2005, the revenue projections, by category, of all mandatory basic plans and organizations created to contribute to their funding are as follows:
(In billions of euros)
You can see the table in the OJ
n° 296 of 21/12/2004 text number 1
For 2004, the revised revenue estimates, by category, of all core mandatory plans and organizations created to contribute to their funding are as follows:
(In billions of euros)
You can see the table in the OJ
n° 296 of 21/12/2004 text number 1
After Article L. 162-5-14 of the Social Security Code, an article L. 162-5-15 is inserted as follows:
"Art. L. 162-5-15. - Physicians referred to in Article L. 6155-1 of the Public Health Code as well as the employed doctors of a health centre referred to in Article L. 6323-1 of the same code are identified by a personal number distinct from the number identifying the structure in which they operate.
"The order in the first paragraph of Article L. 161-33 of this Code specifies the cases in which this number is mandatory on the documents transmitted to the health insurance funds for the reimbursement or care provided by these practitioners. »
I. - Article L. 162-26 of the Social Security Code is amended as follows:
1° The words: "realized as part of the liberal activity of hospital practitioners, or in consultations and actions" are deleted;
2° At the beginning of this article, two paragraphs are inserted:
"The consultations and external acts, as well as those carried out in an emergency department of a health care facility referred to in a, b and c of section L. 162-22-6, are covered by the mandatory health insurance plans under the conditions set out in sections L. 162-1-7 and L. 162-14-1 and within the limits of the rates set out under these sections. The fees for the consultations and the acts so set are used as a basis for calculating the insured's participation, billing the insured's benefits to patients not covered by a health insurance plan, and for the exercise of appeals against third parties.
"For follow-up or rehabilitation and psychiatry activities, the health insurance portion of the consultations and actions referred to in the preceding paragraph is included in the annual allocation referred to in section L. 174-1. » ;
3° It is supplemented by a sub-item:
"The provisions of this section do not apply to consultations and acts carried out by hospital practitioners as part of the liberal activity defined in Article L. 6154-2 of the Public Health Code. »
II. - The 1st of Article L. 174-1-1 of the same code, in its writing resulting from the III of Article 26 of the Social Security Financing Act for 2004 (No. 2003-1199 of 18 December 2003), is replaced by a 1° and 1° bis as follows:
« 1° Psychiatric activities carried out by health facilities referred to in Article L. 174-1;
"1° bis The follow-up and rehabilitation activities carried out by health facilities referred to in Article L. 174-1; "
III. - Section 24 of the Social Security Financing Act 2004 (No. 2003-1199 of 18 December 2003) comes into force on 5 October 2004.
IV. - Section 33 of the Social Security Funding Act 2004 referred to above is amended as follows:
1° In the first paragraph, the date: "October 2004" is replaced by the date: "March 2005";
2° After the first sentence of the third paragraph of I, a sentence is inserted as follows:
"By derogation from the last paragraph of Article L. 162-22-10 referred to above, the rates of benefits established pursuant to this section shall be effective in 2005, effective 1 January. »
3° The A du V is thus modified:
(a) In the first paragraph, after the words: "Hospitalization benefits", the words are inserted: "as well as the consultations and actions mentioned in Article L. 162-26 of the Social Security Code", the word "exempted" is replaced by the word "exempted" and the word "taking" is replaced by the word "taking";
(b) At 1°, after the words: "the Social Security Code", the words are inserted: "or the tariff of the consultations and acts established pursuant to the provisions of Article L. 162-14-1 of the same Code",
(c) It is supplemented by a sub-item:
"By derogation from the provisions of the preceding four paragraphs, organ or tissue collection benefits are, as of 2005, invoiced in full on the basis of the rates established pursuant to the provisions of 1° of I of Article L. 162-22-10 of the same code. » ;
4° In the third paragraph of IV, the year: "2004" is replaced by the year: "2005", and the last sentence is deleted;
5° It is complemented by a VI and a VII as follows:
"VI. - For the years 2005 to 2007, the share of hospital fees, acts and external consultations referred to in Article L. 162-26 of the Social Security Code covered by the mandatory health insurance plans for the care provided in the activities of medicine, surgery, obstetrics and odontology carried out by the health institutions of Guyane referred to in (a) and (b) of Article L. 162-22dit
« VII. - For the years 2005 to 2012, in addition to the elements provided for in the II of Article L. 162-22-9 of the Social Security Code, the national rates of the benefits mentioned in 1° of Article L. 162-22-10 of the same code are fixed taking into account the process of convergence between the national rates of the establishments mentioned in (a), (b) and (c) of Article L. 162-22-6 of the said Code and those of establishments mentioned in the same article, to be completed later, The objective of convergence of rates will be 50 per cent in 2008. »
V. - The II and III of Article 34 of the Social Security Financing Act for 2004 referred to above are repealed.
VI. - 2° of Article 36 of Act No. 2004-810 of 13 August 2004 on health insurance is thus written:
« 2° The last paragraph, in the drafting of the article before the Social Security Financing Act for 2004 (No. 2003-1199 of 18 December 2003), is deleted. »
VII. - 1. In the first paragraph of Article L. 4311-13 of the Public Health Code, after the words "professional activity", the words "voluntary or employee" are inserted and the year: "2003" is replaced by the year: "2005".
2. The Government will submit to Parliament, by 30 September 2005, a report assessing the impact of the provisions of 1 on the recruitment needs of qualified personnel and the financial balance of social security.
The third paragraph of Article L. 162-22-13 of the Social Security Code is supplemented by a sentence as follows:
"This assessment includes an analysis of the appropriateness of the scope of the missions of general interest and assistance to the contractualization of health facilities referred to in the first paragraph, the evolution of the annual amount of the national funding of these missions and the amount of the regional staffing, as well as the criteria for the allocation of the latter to institutions. »
Article L. 162-32-1 of the Social Security Code is supplemented by an 8° as follows:
« 8° Where applicable, aid devices to facilitate the installation of health centres in the areas referred to in Article L. 162-47. Obligations to which health centres benefit from these aids are subject may be adapted by the regional unions of health insurance funds after consultation with the representative organizations of health centres referred to in the first paragraph of this article to take into account the regional situation. »
In the second paragraph (1°) of Article L. 162-47 of the Social Security Code, after the words "liberal health professionals" are inserted the words "and health centres mentioned in Article L. 6323-1 of the Public Health Code".
[Dispositions declared not in conformity with the Constitution by decision of the Constitutional Council No. 2004-508 DC of 16 December 2004. ]
I. - The first paragraph of Article L. 161-39 of the Social Security Code is supplemented by a sentence as follows:
"The companies, institutions, organizations and professionals concerned are required to provide the information it requests for this purpose after making them anonymous. »
II. - At 4° of Article L. 161-45 of the same code, the reference: "L. 245-6" is replaced by the reference: "L. 245-5-1 A".
The funds referred to in Article L. 174-18 of the Social Security Code may consent for a period of two months from the date of the implementation of the new classification of benefits under Article L. 162-22-6 of the same Code, even prior to the date of publication of this Act, from cash advances to private health establishments referred to in Article L. 162-22-6 and to the professional incapacity of health facilities exercising in title
The amount of these cash advances shall be deducted from the amounts due to the invoices for care provided after the implementation of this new classification.
The financial burden resulting from the payment of the cash advances referred to in this article on behalf of the other plans is compensated by the latter according to the rules set out in the decree referred to in Article L. 174-18 of the Social Security Code.
Article L. 753-4 of the Social Security Code is amended as follows:
1° In the first paragraph, the words "in the first and second paragraphs of" are replaced by the word "in" and the same paragraph is supplemented by the words "and in article L. 162-22-7";
2° After the first preambular paragraph, a sub-item reads as follows:
"Products and benefits reimbursable by social security organizations are those mentioned in articles L. 165-1 and L. 162-22-7. » ;
3° The last paragraph is replaced by six subparagraphs as follows:
"An order of Ministers for Social Security, Health, Economy and the Overseas may determine applicable increases:
« 1° At prices or margins, fixed pursuant to Article L. 162-16-4 or Article L. 162-38, or to the flat rates of liability, as provided for in Article L. 162-16, of the reimbursable drugs referred to in the first and fourth paragraphs of Article L. 162-17;
« 2° At the disposal prices established under Article L. 162-16-5 for the drugs mentioned in the second paragraph of Article L. 162-17;
« 3° At the liability rates established pursuant to Article L. 162-16-6 for drugs listed in Article L. 162-22-7;
« 4° At liability rates and, where applicable, at the prices of products and benefits referred to in articles L. 165-1 and L. 162-22-7.
"These increases take into account the special costs that, in each overseas department, strike the cost of these drugs against their cost in metropolis. »
I. - Section 40 of the Social Security Financing Act, 2001 (No. 2000-1257 of 23 December 2000) is amended as follows:
1° After the III, a III bis is inserted as follows:
"III bis. - The fund is also responsible for providing health facilities with the amounts due to expenditures avoided by the implementation of national or local agreements referred to in Article L. 6113-12 of the Public Health Code. » ;
2° In IV, the words "subject to Article L. 174-1" are replaced by the words "public health and private health institutions referred to in Article L. 162-22-6.
II. - The provisions of I are applicable to Mayotte and Saint-Pierre-et-Miquelon.
III. - The amount of participation of compulsory health insurance plans in the Fund for the Modernization of Public and Private Health Institutions is set, for the year 2005, at 405 million euros.
The Government will transmit to Parliament, by 1 October 2005, a report on the implementation of the National Investment Plan "Hospital 2007", including the effects on the management of the health facilities concerned of the investment measures undertaken.
I. - Subject to the rulings of justice, the overall terms of reference for the payment to the hospital radiologist by the public institution, which employs a 20% share of the technical package for the scanographic acts carried out by the practitioner as part of its liberal activity as their regularity is questioned.
II. - Section L. 6154-3 of the Public Health Code is supplemented by a paragraph to read:
"The Scanography Acts give rise to the reversal, for the benefit of the hospital radiologist by the public institution that employs it, of a share of the technical package when these acts are carried out in the context of the liberal exercise of this practitioner. A decree in the Council of State sets the conditions for the application of this provision. »
I. - In the last paragraph of the I of Articles L. 162-22-2, in its drafting of the Social Security Financing Act for 2004 (No. 2003-1199 of 18 December 2003), and L. 162-22-9 and in the penultimate paragraph of Article L. 174-1-1 of the Social Security Code, the words "after which health facilities or services or activities of these institutions" are replaced by the words
II. - The second paragraph of Article L. 227-1 of the same code is supplemented by a sentence as follows:
"This forward-looking goal of city care expenses takes into account changes of any kind following which health or medical or social facilities or activities are placed for all or part under a legal regime or funding different from that under which they were previously placed. »
III. - The last sentence of the third paragraph of Article L. 314-3 of the Code of Social Action and Families is as follows:
"It takes into account developments of any kind following which health or social facilities, services or activities are placed for all or part under a legal regime or funding different from that under which they were previously placed. »
The fifth paragraph (4°) of Article L. 162-47 of the Social Security Code is supplemented by a sentence as follows:
"This program integrates the dissemination of good care guides and good practice recommendations developed by the High Health Authority and the evaluation of their compliance. »
At the 16th of Article L. 322-3 of the Social Security Code, after the words: "The costs of screening examinations" are inserted the words: "and the costs associated with the prevention consultations for minors".
I. - After section 4 of chapter II of title I of Book VII of the Social Security Code, a section 4 bis is inserted as follows:
“Section 4 bis
" Provisions applicable to masters
and documentalists of private education
"Art. L. 712-10-1. - The provisions of articles L. 712-1 and L. 712-3 of the first paragraph of Article L. 712-9 and Article L. 712-10 shall apply to masters and documentalists connected to the State by approval or contract that are in operation in private educational institutions related to the State by contract. »
II. - After sub-section 1 of chapter II, section 2, title II of Book VII of the Rural Code, a sub-section 1 bis is inserted as follows:
"Subsection 1 bis
" Provisions applicable to teachers
and documentation related to the State by contract
"Art. L. 722-24-1. - The provisions of Articles L. 712-1 and L. 712-3, the first paragraph of Article L. 712-9 and Article L. 712-10 of the Social Security Code are applicable to teachers and documentation related to the State by contract that are in operation in associations or bodies responsible for private agricultural educational institutions related to the State by contract. »
III. - The provisions of I and II apply as of September 1, 2005.
By derogation from the provisions set out in articles L. 122-26 of the Labour Code and L. 331-3 of the Social Security Code, women whose pathological pregnancy is recognized as being related to the exposure in utero to diethylstilbestrol (DES) are granted maternity leave from the first day of their work stop under conditions established by decree in the Council of State.
I. - For 2005, the maximum expenditure of the fund established in Article 25 of the Social Security Financing Act for 1999 (No. 98-1194 of 23 December 1998) is set at 106 million euros.
This fund has €60 million for the fiscal year 2005.
II. - In the I of Article 25 of the Social Security Financing Act for 1999 referred to above, the words "8 years" are replaced by the words "9 years".
III. - In the second sentence of the third sentence of the same article, the words: "the different plans are carried out under the conditions defined in Article L. 722-4 of the Social Security Code" are replaced by the words: "the general health insurance scheme, the health insurance schemes of the agricultural professions and the health and maternity insurance scheme of non-working workers in the non-agricultural professions is fixed by decree of the ministers responsible for social security and agriculture".
Article L. 162-15-2 of the Social Security Code is supplemented by two paragraphs as follows:
"Conventions, framework agreement and inter-professional conventional agreements, which have expired or terminated, continue to produce their effects until the publication in the Official Journal of the new conventions or framework agreements and inter-professional treaty agreements or the arbitration regulations that replace them.
"When an agreement referred to in Article L. 162-14-1 is entered into and approved under the conditions set out in Article L. 162-15, the previous agreement shall be deemed to be null and void. »
I. - After the I of Article L. 161-31 of the Social Security Code, it is inserted an Ibi as follows:
"I bis. - Organizations serving the benefits of a basic health insurance plan include on an opposition list the numbers of cards in circulation and in the course of validity lost, stolen or denounced. The conditions for the implementation of this list are set by the national conventions, national agreements and contracts or other applicable provisions mentioned in Article L. 161-34. »
II. - After article L. 162-16-3 of the same code, an article L. 162-16-3-1 is inserted as follows:
"Art. L. 162-16-3-1. - Depending on the terms and conditions determined under sections L. 162-16-1 and L. 161-34, health insurance organizations may undertake, in the event of an advance of total or partial costs granted to the insured, to make the calculation of the amounts due to pharmacists holding an offence on the basis of the information provided by the insured person's card. However, this payment cannot be made when the card is registered on the opposition list referred to in L. 161-31. »
The amount of the overall allocation for the financing of the National Office for Medical Accident Compensation, Iiatrogen Conditions and Nosocomial Infections referred to in Article L. 1142-23 of the Public Health Code is set at €30 million for 2005.
I. - In the first paragraph of section 51 of the Social Security Financing Act, 2004 (No. 2003-1199 of 18 December 2003), the words "exposed to a microbial, toxic, chemical or radiological agent used in the context of a terrorist act" are replaced by the words "exposed to a serious health threat, regardless of its origin or nature".
II. - The contribution of health insurance to the competition fund referred to in Article 51 of the Social Security Financing Act for 2004 referred to above is set in 2004 to 62 million euros.
This contribution is divided between the different regimes according to the rules implemented under the year 2003 for the application of Article L. 174-2 of the Social Security Code.
I. - Article L. 133-4 of the Social Security Code reads as follows:
"Art. L. 133-4. - In case of non-compliance with the pricing or billing rules:
« 1° Acts, benefits and products on the lists referred to in articles L. 162-1-7, L. 162-17, L. 165-1, L. 162-22-7 or falling under articles L. 162-22-1 and L. 162-22-6;
« 2° Transportation charges referred to in Article L. 321-1,
"the care organization shall cover the indu matching with the professional or the institution as a result of non-compliance with these rules.
"The same is true in the case of billing for the reimbursement by health insurance organizations of an unused act or benefits and products not issued.
"The recovery action, which is prescribed by two years from the date of payment of the undue amount, opens with the sending to the professional or the establishment of a notification to pay the amount claimed or to produce, if any, their observations.
"In the event of a total or partial rejection of the comments of the person concerned, the director of the health insurance organization shall, by registered letter, address a stay of the person concerned to pay within one month. Remaining may only involve amounts to the notification. It includes a 10 per cent increase in the amount of unpaid claims on the date of shipment; these increases can be discounted.
"When the detention remains unimpeded, the director of the organization may issue a constraint that, if the debtor is not opposed to the Social Security Court, has all the effects of a judgment and, in particular, gives the benefit of the judicial mortgage.
"A decree in the Council of State defines the modalities for the implementation of the three preambular paragraphs. »
II. - Article L. 133-4-1 of the same code is supplemented by a paragraph as follows:
"The organization referred to in the first paragraph shall, if any, inform, if it may be identified, the health insurance organization complementary to the insured person of the procedure referred to in this section. »
In article L. 141-1 of the Social Security Code, after the words: "work accident and occupational disease", the words "and those relating to their therapeutic care" are inserted.
I. - At the beginning of article L. 711-7 of the Social Security Code, it is inserted a paragraph as follows:
"The participation of the insured referred to in section L. 322-2, and the last paragraph of section L. 432-1 applies to insured persons who fall under one of the special plans referred to in section L. 711-1. »
II. - The provisions of individual or collective contracts, membership bulletins and regulations, collective agreements or agreements, draft agreements proposed by the head of business and ratified by a majority of the persons concerned or unilateral decisions of the employer referred to in Article L. 911-1 of the Social Security Code, relating to guarantees relating to the reimbursement or compensation of health care expenses caused by an accident-2
The revised national objective of health insurance expenditures for all basic mandatory plans is set at 131 billion euros for the year 2004.
The national objective of health insurance expenditures for all basic mandatory plans is set at 134.9 billion euros for the year 2005.
For 2005, the objective of spending on the sickness, maternity, disability and death of all of the mandatory basic plans with more than twenty thousand active or retired contributors holding personal rights is set at 148.3 billion euros.
[Dispositions declared not in conformity with the Constitution by decision of the Constitutional Council No. 2004-508 DC of 16 December 2004. ]
The amount of the contribution of the industrial accidents and occupational diseases branch of the general social security system to the financing of the Asbestos Victim Compensation Fund, referred to in the VII of Article 53 of the Social Security Financing Act for 2001 (No. 2000-1257 of 23 December 2000), is set at 200 million euros for the year 2005.
The amount of the contribution of the occupational accidents and diseases branch of the general social security system to the financing of the Asbestos workers' early termination fund, referred to in the III of Article 41 of the Social Security Financing Act for 1999 (No. 98-1194 of 23 December 1998), is set at €600 million for 2005.
I. - For the benefit of the Asbestos workers' early termination fund established by section 41 of the Social Security Financing Act, 1999 (No. 98-1194 of 23 December 1998), a contribution, due for each employee or former employee on the basis of his or her admission for the benefit of the early termination allowance. This contribution is at the expense of the company that has borne or supports, as part of its contributions for occupational accidents and diseases, the expense of the expenses caused by the occupational illness caused by the asbestos who is reached by the employee or former employee. When the employee is not affected by any occupational illness caused by the asbestos, this contribution is borne by:
1° Of one or more companies whose establishments are mentioned in the first paragraph of I of the same article 41;
2° Of one or more handling companies or of one or more port management bodies for, respectively, professional dockers and port personnel ensuring handling in the ports mentioned in the sixth paragraph of I of the same Article 41.
For the determination of the company or agency responsible for the contribution under 1°, the following rules apply:
(a) When the establishment is operated successively by several companies, the contribution is due by the company that operates the establishment on the date of the employee's admission to the allowance;
(b) When an employee has worked in several enterprises operating separate establishments, the amount of the contribution is divided according to the length of work performed by the employee in these establishments during the period when the asbestos or asbestos-containing materials were manufactured or processed.
For the application of the 2°, where an employee has been employed by several companies or organizations, the amount of the contribution is distributed on the prorated basis of the period worked in these companies or organizations. When a professional docker admitted to the allowance is raised or raised from the category of intermittent professional dockers within the meaning of Article III L. 511-2 of the Code of Maritime Ports, the contribution corresponding to the period of intermittence is distributed among all labour employers in the port, within the meaning of Article L. 521-6 of the same code, to the prorata of total gross paid remuneration
The contribution is not due for the first recipient admitted in a calendar year.
II. - The amount of the contribution varies depending on the age of the beneficiary at the time of admission to the benefit of the allowance. It is equal, by beneficiary of the allowance, to 15% of the gross annual amount of the allowance increased by 40% for old-age and supplementary pension insurance contributions at the expense of the fund, multiplied by the number of years between the age mentioned above and the age of sixty years.
The amount of the contribution, which cannot exceed two million euros per calendar year for each indebted person, is capped, for companies in receipt of the contribution under I, to 2.5% of the total mass of salaries paid to staff for the last known year.
Companies placed in recovery or judicial liquidation are exempt from the contribution.
III. - The contribution is called, recovered and controlled, according to the rules and under the guarantees and penalties applicable to the recovery of the contributions of the general system, by the organizations referred to in Article L. 213-1 of the Social Security Code designated by the Director of the Central Agency of Social Security Agencies.
It is due on the first day of the third month of each calendar quarter for persons entering the device during the previous quarter.
For employees or former employees who are employed or who have taken note of the social protection regime of persons employed in the agricultural professions, the contribution due is called, recovered and controlled by the funds of agricultural social mutuality according to the rules and under the guarantees and penalties applicable to the collection of contributions due to the social protection scheme of persons employed in the agricultural professions. The deadline for payment of the contribution is the fifteenth day of the second month of each calendar quarter for persons entering the device in the previous quarter.
IV. - A decree sets out the modalities for the application of this article.
V. - The provisions of this section apply to admissions for the benefit of the anticipated termination allowance issued as of 5 October 2004.
After the V of Article 41 of the Social Security Financing Act for 1999 mentioned above, a V bis is inserted as follows:
"V bis. - The registration of the establishments or ports referred to in I on the list giving employees the right to benefit from an early termination of activity and the corresponding allocation or the modification of such registration may only take place after the information of the employer concerned. The decision to register an establishment or amendment must be notified to the employer. It is displayed on the workplace. »
In the fourth paragraph of Article L. 242-5 of the Social Security Code, the words "financial balance of social security" are replaced by the words "financial balance of the branch".
The amount of the payment referred to in Article L. 176-1 of the Social Security Code is set, for the year 2005, to 330 million euros.
For 2005, the objective of expenditures of the occupational accidents and diseases industry of all mandatory basic plans with more than twenty thousand active or retired contributors holding clean rights is set at 10.5 billion euros.
[Dispositions declared not in conformity with the Constitution by decision of the Constitutional Council No. 2004-508 DC of 16 December 2004. ]
I. - The 1st of Article L. 211-10 of the Code of Social Action and Families is thus written:
« 1° A special fund provided annually by a payment made by the National Fund for Family Allowances and the Central Fund for Agricultural Social Mutuality prorated the amount of family benefits paid the previous year by each of them.
"The contributions of these two organizations and the amount of the special fund are determined by order of the Minister for Social Security and the Minister for the Family. The special fund shall be established under the following conditions:
“(a) A first part, intended to cover the general missions referred to in Article L. 211-3 of this Code, evolves annually under the conditions defined in the first paragraph of Article L. 551-1 of the Social Security Code;
“(b) A second part is intended to fund actions defined by conventional means between the National Union of Family Associations and the Minister responsible for the family. It is revalued each year within the limit of the rate of change observed in the previous calendar year of the amount of family benefits. In the event of the creation or deletion of one of these benefits, the rate of change in the year in which the creation or deletion occurs is that corresponding to the average of the evolution rates selected for the previous three calendar years.
"Family benefits for the purposes of this section are:
" - the benefits referred to in Article L. 511-1 of the Social Security Code, including those paid in the departments referred to in Article L. 751-1 of the same code, with the exception of the single parent allowance;
" - Young Child Allowance, Adoption Allowance and Parental Education Allowance paid under applicable regulations prior to January 1, 2004.
"Similar to family benefits, for the purposes of this section, childcare allowance at home and family assistance for the employment of a registered nursery assistant paid under the applicable regulations prior to January 1, 2004.
"The terms and conditions for the payment of the special fund and its distribution between the unions of family associations, the conditions under which federations, confederations or family associations adhering to the unions can benefit from it and the methods for evaluating its use are set by regulation; "
II. - The amount of the special fund mentioned in the 1st of Article L. 211-10 of the Code of Social Action and Families is set for 2005 to €24.31 million, as follows:
1° 19 448 000 EUR for the first part;
2° 4,862,000 EUR for the second part.
The share of expenses covered by the National Fund for Family Allowances referred to in 5° of Article L. 223-1 of the Social Security Code is equal to a fraction of 60% for 2005.
For 2005, the objective of spending on the family branch of all mandatory basic plans with more than 20,000 active or retired contributors holding their own rights is set at €46.2 billion.
I. - The third part of section 19 of Act No. 2004-803 of 9 August 2004 on the public service of electricity and gas and electrical and gas companies is amended as follows:
1° The first paragraph is supplemented by a sentence as follows:
"A portion of the contribution due to the National Pension Insurance Fund for Employees under the conditions set out in the third paragraph of this 3rd paragraph is paid to the Retirement Reserve Fund referred to in Article L. 135-6 of the Social Security Code. » ;
2° The third paragraph reads as follows:
" - for the National Pension Insurance Fund and for the Retirement Reserve Fund, by decree of ministers responsible for the budget and social security; direct payments made between 2005 and 2024 to the National Pension Insurance Fund for Employees are guaranteed by the State under conditions defined in the Financial Law; »
3° It is supplemented by a sub-item:
"The decision of the Ministers responsible for the budget and social security referred to in the third paragraph of this 3rd paragraph also sets out the parameters for calculating the exceptional, lump-sum and liberatory contribution due by the National Fund of Electrical and Gas Industries to the National Insurance Fund for Employee Old Age Insurance. It is submitted for advice to the Board of Directors of the Caisse nationale d'assurance vieuxsse des travailleurs wages; "
II. - The Social Security Code is amended as follows:
1° In the second paragraph of Article L. 135-6, after the word "mission", is inserted the word "main";
2° The same article is supplemented by two sub-items:
"The Retirement Reserve Fund also provides financial management for a portion of the outstanding, lump-sum and liberating contribution to the National Pension Insurance Fund for Employees pursuant to Article 19 of Act No. 2004-803 of 9 August 2004 relating to the public service of electricity and gas and to electrical and gas companies.
"The conditions and results of the management of this part of the contribution are reviewed annually in the schedule to the accounts of the fund. This part of the contribution and its financial products, net of the expenses incurred by the fund, are returned to the National Old Age Insurance Fund of employed workers starting in 2020, under conditions fixed by agreement between the National Old Age Insurance Fund of employed workers and the Retirement Reserve Fund. » ;
3° After the second paragraph of Article L. 135-10, it is inserted a paragraph as follows:
"By derogation from the previous paragraph, in exceptional cases, on a temporary basis and in order to preserve the security of assets held by the fund, their financial management may be assured by the fund without resorting to the investment companies referred to in the paragraph. The conditions for the application of this exemption are set by joint decree of ministers responsible for the economy and social security. » ;
4° The second paragraph of Article L. 135-12 is as follows:
"They certify annual accounts and issue a limited review report on the semi-annual interim accounts of the fund before they are submitted by the supervisory board to the supervisory board and are published. »
III. - Article 18 V of Act No. 2004-803 of 9 August 2004 referred to above is amended as follows:
1° In the second paragraph, the words "1% and 10%" are replaced by the words "10% and 20%" and the words "10% and 20%" are replaced by the words "20% and 35%";
2° In the third paragraph, the words "10% and 20%" are replaced by the words "15% and 25%".
IV. - Section 18 of the Act is amended as follows:
1° The IV is supplemented by the words: "or, by option of the latter, at the time of the flow; in this case, it is due in any case at the time of the deposit or price if it precedes the flow";
2° The first sentence of the first paragraph of the VI is replaced by four sentences as follows:
"The rate contribution is reported and liquidated monthly or quarterly, depending on the amount. It shall be paid at the time of the filing of the declaration. The contribution is recovered and controlled by the National Fund for Electrical and Gas Industries under the same conditions as the contributions referred to in the first paragraph of the III of Article 16. The specific terms and conditions for the recovery of the contribution, including increases, penalties, reserve or lump sum taxation, are specified in the conditions set out in the VII.
I. - The age of sixty years referred to in 1° of Article L. 24 of the Civil and Military Pension Code is lowered for officials affiliated to the National Pension Fund of Local Government Employees who justify, in this plan and, where applicable, in one or more other mandatory plans, a period of insurance or recognized periods equal to at least one hundred and sixty-eight quarters:
1° Effective January 1, 2008, at fifty-six years for public servants who justify a period of activity that gave rise to dependant contributions at least equal to one hundred and sixty-eight quarters and began their business before the age of sixteen years;
2° Effective July 1, 2006, at fifty-eight years for public servants who justify a period of activity that gave rise to dependant contributions at least equal to one hundred and sixty-four quarters and began their business before the age of sixteen years;
3° Effective January 1, 2005, at fifty-nine years for public servants who justify a period of activity that gave rise to dependant contributions at least equal to one hundred and sixty quarters and began their business before the age of seventeen.
For the application of the age of beginning of activity defined at 1°, 2° and 3°, are considered to have started their activity before the age of sixteen or seventeen years the officials justifying:
- an insurance period of at least five quarters at the end of the year in which, respectively, their sixteenth or seventeenth anniversary occurred;
- either, if they were born in the fourth quarter and do not justify the duration of insurance provided for in the preceding paragraph, for a minimum of four quarters of insurance in respect of the year in which, respectively, their sixteenth or seventeenth anniversary occurred.
For the application of the duration of the activity that gave rise to the expense of the employees defined in 1°, 2° and 3°, are deemed to have given rise to contributions:
- national service periods, one quarter per period of at least ninety days, consecutive or not. When the period covers two calendar years, it can be assigned to either of these years, the most favorable solution being retained;
- the periods during which the grievors were placed on statutory sick leave and the periods included as insurance periods in one or more other mandatory sickness, maternity and temporary incapacity plans.
These periods are deducted respectively within four quarters and without the number of quarters that have resulted in contributions or deemed to exceed four for the same calendar year.
For the purposes of this same period of activity that gave rise to employee dependants' contributions, a number of quarters in excess of four in each calendar year in which the insured person was successively or simultaneously affiliated to several of the plans considered.
For the purposes of the condition of an insurance life or of an equivalent recognized period defined in the first paragraph of this article, consideration shall be given to the bonus for a child referred to in article L. 12 of the Code of Civil and Military Retirement Pensions, the increases of insurance duration referred to in articles L. 12 bis and L. 12 ter and the periods of interruption or reduction of activity referred to in article 9 of the same article.
II. - The year in which the conditions set out in I of this section are met is the year for the application of the provisions of II and III of section 66 of Act No. 2003-775 of 21 August 2003 on pension reform, provided that the grievor requests to benefit from the provisions of this section prior to his sixtieth anniversary.
III. - The provisions of this article shall enter into force on 1 January 2005.
[Dispositions declared not in conformity with the Constitution by decision of the Constitutional Council No. 2004-508 DC of 16 December 2004. ]
For 2005, the objective of expenditures of the old-age branch and the overall basic mandatory regimes with more than twenty thousand active or retired contributors holding clean rights is set at 156,7 billion euros.
For 2004, the revised spending targets per branch of all mandatory base plans with more than twenty thousand active or retired equity holders are set to the following amounts:
(In billions of euros)
You can see the table in the OJ
n° 296 of 21/12/2004 text number 1
I. - The title of Chapter VIII bis of Title III of Book I of the Social Security Code is as follows: "Common provisions for contributions recovered by organizations recovering from the general regime".
II. - Article L. 138-20 of the same code is as follows:
"Art. L. 138-20. - Contributions established in sections L. 138-1, L. 138-10, L. 245-1, L. 245-5-1 and L. 245-6 shall be recovered and controlled, in accordance with the rules and under the sanctions and guarantees applicable to the collection of assessments of the general compensation scheme, by organizations referred to in Article L. 213-1 designated by the Director of the Central Agency for Social Security Agencies.
"The contribution established in Article L. 137-6 is recovered and controlled by the Central Agency of Social Security Agencies, under the conditions set out in Article L. 225-1-1. The agency may collect the assistance of unions for the recovery of social security and family allowance contributions and general social security funds from overseas departments, including by the provision of agents of these bodies, which are responsible for monitoring.
"The control officers are empowered to collect from the subject-matter all information that would allow for control of the base and scope of contributions. »
III. - Section L. 138-21 of the same code is repealed.
IV. - In sections L. 138-7, L. 138-17, L. 245-3 and L. 245-5-5 of the same code, the words: "at 3° of Article L. 225-1-1 and Articles L. 138-20 to L. 138-23" are replaced by the words: "at articles L. 138-20 to L. 138-23". In section L. 138-19 of the same code, the words: "the Central Agency of Social Security Organizations" are replaced by the words: "the union of recovery of social security and family allowance contributions designated for this purpose".
V. - The provisions of this section apply for the recovery of assessed contributions due as of 1 January 2005, with the exception of the balance of the contribution provided for in the VII of Article 12 of the Social Security Financing Act for 2004 (No. 2003-1199 of 18 December 2003) and the regularization of the contribution provided for in Article L. 138-4 of the Social Security Code acting on 31 March 2005, including the recovery and control of
Organizations referred to in the first paragraph of Article L. 138-20 of the same Code shall regain the rights and obligations, actions and prosecutions, debts and receivables of the Central Agency of Social Security Organizations, born out of recovery and control operations that took place until 31 December 2004, with the exception of those relating to the balance and regularization referred to in the preceding paragraph.
I. - The social security code is amended as follows:
1° At the beginning of article L. 212-3, an I is inserted as follows:
"I. - The Maritime Family Allowance Fund provides for the benefit of persons affiliated with the special social security scheme of seafarers.
"It also ensures for these people:
« 1° The recovery of family allowance contributions due by employers and self-employed persons in accordance with the rules and the guarantees and penalties applicable to such recovery by unions for the collection of social security and family allowance contributions and general social security funds;
« 2° The recovery of the generalized social contribution in accordance with the provisions of articles L. 136-1 and following;
« 3° The recovery of the contribution for the reimbursement of social debt established by Article 14 of Order No. 96-50 of 24 January 1996 on the reimbursement of social debt;
« 4° The control and the litigation of the recovery at 1°, 2° and 3°. » ;
2° The 6th of Article L. 752-4 is supplemented by the words: "with the exception of the competences mentioned in 1°, 2°, 3° and 4° of Article L. 212-3 of this Code which are exercised in overseas departments by the Maritime Family Allowance Fund".
II. - Subject to judicial decisions taken in force of measure, are validated as of 1 January 1999 the recovery of the family allowances, the general social contribution and the contribution for the reimbursement of the social debt due by the persons affiliated to the special system of social security of the seafarers, as soon as they were made in metropolis or in the overseas departments, in their name or for the general account
I. - In article L. 174-2 of the Social Security Code in its applicable writing effective January 1, 2005, the words: "hospitalization benefits mentioned in the 1st of article L. 162-22-6 of the health facilities referred to in a, b and c of the same article and "are deleted.
II. - After article L. 174-2 of the same code, an article L. 174-2-1 is inserted as follows:
"Art. L. 174-2-1. - The portion of the health insurance coverage for the hospitalization benefits provided for in the 1st of section L. 162-22-6 and carried out in the health facilities referred to in a, b and c of the same article, the drugs and products and benefits referred to in section L. 162-22-7 and the acts and consultations referred to in section L. 162-26 shall be refunded to the establishments on behalf of the whole plan referred to in section 174-2.
"A decree in the Council of State, taken after advisory opinion of the representative organizations of the health institutions, determines the modalities for the application of this article, including the respective responsibilities of the body and the body to which the beneficiary of the care depends, in particular the conditions and times in which the body can verify the amounts to be refunded and authorize their payment. »
III. - Article L. 174-18 of the same code is amended as follows:
1° The first sentence of the first paragraph is as follows:
"Hospitalization costs for the care provided in private health facilities referred to in the d and e of section L. 162-22-6, covered by mandatory health insurance plans, are reimbursed, on behalf of all health insurance plans, by the primary health insurance fund in the exchange of which the institution is located. » ;
2° The last paragraph is as follows:
"A decree in the Council of State, taken after the advice of the representative organizations of health institutions, determines the terms and conditions for the application of this article, including the respective responsibilities of the body and the body to which the beneficiary of the care depends, in particular the conditions and times in which the body can verify the amounts to be refunded and authorize their payment. »
IV. - The D of the V of Article 33 of the Social Security Financing Act for 2004 (No. 2003-1199 of 18 December 2003) is supplemented by four paragraphs as follows:
"The additional annual allowances referred to in 2° of the A of the V of this Article shall be paid by twelfth by the credit union referred to in Article L. 174-2 of the Social Security Code.
"For the years 2005 and 2006, the distribution of the amounts paid under the preceding paragraph to the establishments referred to in (a), (b) and (c) of section L. 162-22-6 of the same code, between the various mandatory health insurance plans is carried out under the conditions set out in section L. 174-2 of that Code. Similarly, by derogation from Article L. 162-22-15 of the same Code, the amounts paid under the annual packages referred to in Article L. 162-22-8 of this Code and the annual funding of the missions of general interest and assistance to the contractualization referred to in Article L. 162-22-13 are also apportioned in accordance with the terms set out in Article L. 174-2 of the same Code.
"For the years 2007 to 2012, the distribution between the mandatory health insurance plans of the amounts paid for the annual supplementary endowment to the establishments referred to in a, b and c of section L. 162-22-6 of the same code is carried out each year on the prorated basis of the costs of hospitalization for the care provided the previous year and supported by each of these plans in the course of the activities of medicine, surgery, obstetology of these institutions
"The modalities for the implementation of the three preceding paragraphs are specified by decree in the Council of State. »
Chapter IV bis of title I of Book I of the Social Security Code is supplemented by an article L. 114-6 as follows:
"Art. L. 114-6. - The accounts of social security regimes and organizations must be regular, sincere and give a true picture of their heritage and financial situation.
"The annual and infra-annual accounts of basic social security organizations, presented by the accounting officer, established under his or her responsibility and covered by the director, are transmitted to the national agency responsible for their centralization. The latter validates these accounts and establishes the combined account of the branch or recovery activity, or the plan.
"National social security agencies that manage a basic mandatory system transmit their annual accounts to the Minister for Social Security and the Court of Auditors.
"National social security agencies that manage a basic mandatory system with a network of local or regional funds transmit annual combined accounts to the Minister for Social Security and the Court of Auditors.
"The accounts of agricultural social protection schemes are also transmitted to the Minister of Agriculture.
"The terms and conditions of application of this article are defined by decree. »
Chapter IV bis of title I of Book I of the Social Security Code is supplemented by an article L. 114-7 as follows:
"Art. L. 114-7. - The national bodies referred to in the second paragraph of Article L. 114-6 are responsible for alerting the Government and the Parliament in the event of changes in the expenditures of the branch or regime manifestly incompatible with the fulfilment of the objectives passed by Parliament in the Social Security Financing Act.
"The Government shall inform the relevant committees of the two assemblies of the measures taken or envisaged to remedy the matter. »
The cash requirements of mandatory base plans with more than twenty thousand active or retired contributors with their own rights and organizations whose mission is to contribute to their financing may be covered by non-permanent resources within the following limits:
(In millions of euros)
You can see the table in the OJ
n° 296 of 21/12/2004 text number 1
Other mandatory base plans with more than twenty thousand active or retired contributors with their own rights, where they have an autonomous cash pool, are not allowed to use non-permanent resources.
This law will be enforced as a law of the State.
A N N E X E
REPORT ON THE ORIENTATIONS OF HEALTH AND SOCIAL SECURITY POLICY AND THE OBJECTIVES OF THE GENERAL CONDITIONS OF THE FINANCIAL EQUIPMENT OF SOCIAL SECURITY
Our social security model has considerable advantages: it makes it possible for everyone to have access to quality care, regardless of age or income. It guarantees our seniors, through a system of solidarity distribution, high-level pension benefits. It is the foundation of an ambitious family policy that supports our demography, helps families in difficulty and allows to reconcile family life and professional life. This model, finally, makes it possible to build real solidarity with older people like people with disabilities who need help and support.
Its preservation and consolidation are the priorities of the Government. The latter has been engaged for two years in a series of reforms to adapt our health and social security system to economic and social changes, including population ageing.
The various social security regimes are faced with common challenges that lead to structural financial difficulties and a challenge to traditional organizations and management modes.
To address these challenges, the Government is focusing on a method: structural responses from a dialogue with all partners.
The reform of pensions, by the Act of 21 August 2003, was the first response to these challenges by ensuring the sustainability of our system by distribution and by strengthening its equity.
The "Aging and Solidarity" plan with the allocation of very important new financial resources for policies for the care of older persons and persons with disabilities responded in a second time to a strong need for our society.
Finally, the Act of 13 August 2004 on health insurance deeply reformes our health care and insurance system to cope with the financial crisis of health insurance and to improve the organization of care in our country.
Through these three major reforms, developed in close consultation with all stakeholders, the Government has taken its responsibilities to ensure the sustainability of our social security model.
1. Health and health insurance policy
1.1. Strengthening public health policy
and Safety
The vote of the Public Health Policy Act of 9 August 2004 lays the foundation for a renewal of public health policy.
While France has a health care system among the best in the world, in terms of health indicators, it presents two weaknesses: an important premature mortality and health inequalities that are stronger than in other countries between the population categories, the sexes, or the different regions.
The Act of 9 August 2004 provides for a rebalanced health organization to benefit from the prevention policy. It is the responsibility of the State to lead the programmes of action that will address the major public health issues. It will do so in the light of the public health objectives contained in the report annexed to the Public Health Policy Act.
This construction of a true public health and prevention policy, for health education and the promotion of health, also involves a local decline, in order to be adapted to the populations to which it addresses and their living environment. This is the goal of regional public health groups (GRSP) that bring together all regional actors involved in these policies. In particular, the specific organizational patterns will be taken into account, in particular the health organisation scheme, the health education scheme, the mental health plan, etc. The first GRSP will be operational during 2005.
The Government has also set five main priorities: the fight against cancer, environmental health, including occupational health, violence and risk behaviour, rare diseases and, finally, the quality of life of people with chronic diseases.
The Government is committed to carrying out the necessary actions to obtain better care for patients after their stay in psychiatric emergency, including paedo-psychiatric. It is necessary to better adapt the care of these patients to the hospital and the open structures.
The fight against smoking like road safety policy is undisputable success. Nearly 1.8 million people will have quit smoking in 2004, while the number of deaths on the road will have dropped this same year by more than 10%.
The Government is committed to carrying out the necessary actions to achieve a concrete reduction in the consumption of narcotic drugs. In particular, there is a need to provide treatment for drug users.
The National Health-Environment Plan, presented by the Government in June 2004, sets out the objective of carrying out the necessary actions by 2008 to prevent environmental pathologies, including cancers, better inform the public and protect sensitive populations. It addresses all risk factors, whether chemical substances or extreme climatic events, and all exposure settings, from occupational exposures and outdoor air to individual habitat.
Renovating public health policy also requires a strengthening of the health security system. The organization of health safety will be improved by more clearly defining the responsibilities of different actors. This is the case of the Health Watch Institute, whose ongoing monitoring mission on the state of health of the population is reinforced by the Public Health Policy Act and its involvement in health care and alert management.
1.2. Health insurance reform
In the face of the three-fold crisis of financing, organisation and legitimacy through health insurance, the Government began health insurance reform in 2004 by the law of 13 August 2004.
On the basis of the report of the High Council for the Future of Health Insurance, this reform ensures the sustainability of our health and health insurance system by creating the conditions for a new health care organization, reshaping the governance of health insurance organizations and ensuring the financial viability of the branch.
The establishment of the personal medical record and the identification of a treating physician will help to organize more coherent care courses, guaranteeing a better quality of care. It will also be promoted by the High Health Authority's development of good practice repositories that are effectively used by health professionals. The Health Insurance Act also provides for an obligation to evaluate professional practices for physicians.
The governance of health insurance is adapted to give councils a real leadership power and to clarify management responsibilities. The National Union of Health Insurance Funds will implement a new partnership with health care professionals and supplementary coverage organizations.
The establishment of a real medical mastery of health insurance expenses also requires this renewal of the conventional dialogue. It also involves the mobilization of the entire health insurance network in order to combat unwarranted spending, especially in the area of work stops and prescriptions.
This medical control will have to bear fruit in conjunction with a drug policy that aims to reconcile the requirements of savings with the enhancement of innovation and research.
The policy of developing generic drugs will be amplified, with the acceleration of their marketing and the mobilization of all actors. A generic drug monitoring committee will allow the Economic Committee for Health Products to apply the flat rates of liability if the use of these products does not develop sufficiently.
The implementation of a charter of medical visits, the adaptation of conditioning to the treatment of chronic diseases and the monitoring of the use of expensive medicines in the hospital will also allow to moderate the volumes thanks to the encouragement of proper treatment.
In addition, health insurance will adapt the care of health products according to the recommendations of the High Health Authority.
Finally, as part of the triennial conventional policy, the Economic Committee for Health Products will continue to actively manage prices based on the product life cycle and the state of competition.
The reform of health insurance, through the savings thus made and the increase in revenues determined in the Act of 13 August 2004, will allow a return to the financial balance in 2007. The Social Security Funding Act 2005 reflected in its financial balances the first step in this recovery.
In order to combat desertification, isolation and security problems, the Government promotes initiatives for the creation of rural and urban difficult medical homes. This will also help maintain the permanence of care.
1.3. A new policy for older persons
and Persons with Disabilities
The new policy for older persons and persons with disabilities is part of the Prime Minister's perspective on 6 November 2003 to conduct a solidarity reform for dependent persons, which had a first translation with the creation, by the Act of 30 June 2004 on solidarity for the autonomy of older persons and persons with disabilities, of the National Fund for Solidarity for Self-Government (CNSA).
The rethinking of disability policy is under way with the bill on equal rights and opportunities, participation and citizenship of persons with disabilities.
Among the three priority projects of the President of the Republic for the quinquennium is the full integration of persons with disabilities in our society, from school to company, home and specialized agency. The policy for persons with disabilities, which is largely interdepartmental, is designed to enable them to exercise a choice of life by facilitating access to common law while providing them with appropriate devices.
These guidelines are a profound reform of disability policy around three areas:
- the guarantee given to persons with disabilities of the free choice of their life project by offering to each person, in a comprehensive and individualized approach, the most appropriate solutions. The right to compensation is realized in particular by the creation of a compensation benefit that supports all or part of the costs associated with human aids, technical aids or housing development;
- the recognition of everyone ' s right to live in dignity and to fully exercise his or her citizenship requires the promotion in each sphere of common law. The effective participation of persons with disabilities in social life should be ensured, whether in school, vocational integration or accessibility;
- and to allow an autonomous life, it is necessary to ensure that every person with disabilities has sufficient means of existence. Income support benefits will be reformed by abolishing age barriers and encouraging social integration through a better combination of activity income.
In order to provide financial support for this development, CNSA, under the terms of the Act, has a mandate to fund activities for persons with disabilities. This is mainly the financing of the compensation benefit and a contribution to the financing of the creation of places of establishments and services announced in January 2004.
In this context, the health insurance credits for persons with disabilities will consolidate the offer of collective compensation in respect of medical and social facilities, ensuring the continuation of the seating plan.
With regard to the section on older persons of the multi-year plan "Aging and solidarity", the main actions are:
- the continued modernization of shelters for dependent elderly people;
- the creation of new home nursing services, which provide a more satisfactory response to the growing aspiration of dependent elderly people to continue living at home;
- the opening of day-to-day reception services, temporary accommodation or any other alternative care offered to older persons, including people with Alzheimer's disease or related diseases. These places are designed to expand the range of responses available to both the elderly and their families: the Alzheimer plan announced in September 2004 will help to better meet the growing needs of degenerative diseases.
1.4. Development of breast cancer prevention
The systematic screening by a mammography must be strengthened throughout the territory for women over fifty years of age, with the aim of better prevention, and for the younger ones clear and adapted information by the generalist should be carried out during the visits.
2. The industrial accident branch
2.1. Negotiations on the future of the branch
In accordance with the provisions of section 54 of the Health Insurance Act of August 13, 2004, employers' professional organizations and union organizations of representative employees at the national level are invited to submit to the Government and Parliament, within one year, proposals on the future of occupational accidents and occupational diseases, including on its governance and the evolution of conditions for the prevention and repair of occupational accidents and diseases.
A convention of objectives and management between the State and the industry occupational accidents and diseases will in particular engage the branch in a program to improve the quality of the service rendered and will significantly expand its range of services offered to different audiences.
2.2. Modernization of pricing
The level of technical complexity that has been achieved by the work accident insurance pricing system through successive reforms makes it an extremely heavy system that needs to be renovated. Proposals will be forwarded by the Government to social partners and will be discussed as part of the negotiation on the future of the industry.
2.3. Compensation for asbestos victims
Following the definition in 2003 of its compensation scale, the Asbestos Victims Compensation Fund (FIVA) now fully assumes its duties. The number of files filed with IFA continues to increase and is expected to reach 10,000 files in 2005.
In addition, following the recognition by the Council of State of the State's faulty deficiency, the Government will initiate, in the autumn, with all concerned actors, social partners and associations of victims, a dialogue to consider the necessary developments of all judicial and extrajudicial procedures to guarantee a high level of compensation and better legal security.
The use of an early cessation of activity for workers exposed to asbestos is also experiencing very sustained growth. The introduction of a contribution to the burden of companies that have exposed some of their employees to the asbestos will share the financing of this device and, in some cases, fight against the misused uses of the device.
3. The family branch
3.1. Further development
of the reception of young children
The introduction of the Child Care Benefit (WYP) as of January 1, 2004, not only made it possible to simplify the assistance provided to parents of young children, but also to significantly improve it, both in terms of basic arrangements and in terms of assistance in the conciliation of family and professional life.
The goal in 2005 in the field of early childhood is to ensure the recovery of the EYP, including the basic allowance and the birth allowance to be paid, on a cruise regime, 200,000 more families than in 2003, and to continue the development of the childcare offer.
In this regard, the Government will implement the renovation of the status of maternal and family assistants as of 1 January 2005; it will ensure the rise of the plan for the creation of 20,000 places of nursery and will generate the growing involvement of companies in joint financing of nurseries and in helping to reconcile the family and professional life of their employees through the "family tax credit".
3.2. The accompaniment of adolescence
The Government will implement in 2005 the twelve measures announced at the Family Conference of 29 June 2004 in the areas of personal commitment, health and leisure.
In order to better take into account the specific health needs of adolescents, a personalized fifth-class health interview will be established to identify as soon as possible the health and social disorders that can alter development. In addition, new youth homes will be created to facilitate the networking of actors around adolescents and their families in health matters and to create places of listening and information for adolescents.
Tax exemptions will facilitate access to paid work during the holidays.
Finally, in order to develop the autonomy of the adolescent, the 2004-2007 objective and management convention will include the necessary guidance for the development of a social action facilitating the access of adolescents to sports, leisure and culture.
3.3. Improving support for fragile families
and the integration of population issues
The 2005 Family Conference will be devoted to supporting fragile families and demographic issues.
It will be an opportunity to analyze the current system of benefits (family benefits and housing) but also to redefine the objectives of the social action of the family branch in relation to the problems related to the composition of families and their family, economic and social constraints.
The work of the 2005 Family Conference will be carried out in close consultation with all partners and experts, as part of working groups launched in early November.
3.4. Reform of the adoption system
The reform of the adoption system will be implemented. It consists of:
- better prepare and assist adoption candidates;
- reshaping the framework of international adoption with, in particular, the creation of a French agency for adoption;
- improve the care, monitoring and health of adopted children;
- promote cooperation in child protection.
The Government will propose a solution for women civil servants who adopted one or more children before 1 October 1978 and who do not benefit from service renewal for the calculation of their retirement.
4. The old-fashioned branch
The year 2004 saw the implementation of the guidelines laid down by the Act of 21 August 2003 on pension reform, with the publication of more than sixty regulatory measures on the eighty-three prescribed by law, which will:
- to ensure a high level of retirement through the extension of the duration of activity and the duration of insurance, including the first stage of convergence of contribution periods in the public and private sectors and the institution on January 1, 2004 of the "surcote" and the cumulative retirement employment;
- to preserve equity and the spirit of social justice, with the early retirement for long careers and workers with disabilities, the increase of the minimum pension, the reform of reversion and the creation of the additional pension scheme for public servants;
- to allow everyone to freely build their retirement, thanks to the easing of the breakout in the event of an incomplete career, the revival of the progressive retirement, the redemption of contributions for years of study or incomplete and the launch of the popular retirement savings plan.
During the year 2005, the rise of several devices - early retirement, extended insurance duration - will be the subject of particular attention. An initial assessment of the effects of devices for the continued activity of older employees may be carried out. Finally, the public interest group responsible for the information of insured persons on their pension rights was established last July, and the tools for assessing the predictable amount of rights will be made available to the public.
Done in Paris, 20 December 2004.
Jacques Chirac
By the President of the Republic:
The Prime Minister,
Jean-Pierre Raffarin
The Minister of the Interior,
of Internal Security
and local freedoms,
Dominique de Villepin
Minister of Employment, Labour
and social cohesion,
Jean-Louis Borloo
The Minister of Solidarity,
health and family,
Philippe Douste-Blazy
The Seal Guard, Minister of Justice,
Dominica Perben
Minister of Economy,
finance and industry,
Hervé Gaymard
Minister of Equipment, Transportation,
of land use,
tourism and the sea,
Gilles de Robien
Minister of Agriculture, Food,
fisheries and rurality,
Dominic Bussereau
The overseas minister,
Brigitte Girardin
Minister Delegate inside,
Marie-Josée Roig
Minister for Budget
and budgetary reform,
Government spokesperson,
Jean-François Copé
Minister for Labour Relations,
Gérard Larcher
State Secretary for Health Insurance,
Xavier Bertrand
State Secretary for Transport
and the sea,
François Goulard
State Secretary for Agriculture,
food, fishing
and Rural Affairs
Nicolas Forissier
(1) Act No. 2004-1370.
- Preparatory work:
National Assembly:
Bill No. 1830;
Report of Mr. Bernard Perrut, Jean-Pierre Door, Ms. Marie-Françoise Clergeau and Mr. Georges Colombier, on behalf of the Cultural Affairs Committee, No. 1876;
Opinion of Mr. Yves Bur, on behalf of the Finance Committee, No. 1877;
Discussion on 26-28 October 2004 and adoption on 2 November 2004.
Senate:
Bill, adopted by the National Assembly, No. 53 (2004-2005);
Report of MM Alain Vasselle, André Lardeux, Dominique Leclerc and Gérard Dériot, No. 57 (2004-2005);
Opinion of Mr. Jean-Jacques Jegou, on behalf of the Finance Committee, No. 58 (2004-2005);
Discussion on 16-18 November 2004 and adoption on 18 November 2004.
National Assembly:
Bill, amended by the Senate, No. 1932;
Report of Mr. Bernard Perrut, on behalf of the Joint Parity Commission, No. 1954;
Discussion and adoption on 2 December 2004.
Senate:
Report of Mr. Alain Vasselle, on behalf of the Joint Parity Commission, No. 71 (2004-2005);
Discussion and adoption on 2 December 2004.
- Constitutional Council:
Decision No. 2004-508 DC of 16 December 2004 published in the Official Gazette of this day.
