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The highly controversial payment reform of dentists in France: seeking a new compromise after the 2017 strike

Research output: Contribution to journalArticle

Original languageEnglish
JournalHEALTH POLICY
Early online date11 Oct 2018
DOIs
Publication statusE-pub ahead of print - 11 Oct 2018

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Abstract

France possesses a mixed public-private oral health system with no out of pocket payments for most routine dental treatments. The "Convention" regulates tariffs between the elected dental trade unions, the National Health Insurance and Complimentary Health Insurers. It is periodically revised and negotiated by the three parties in order to introduce new procedures, improve the access to dental care of the population and to adjust procedure costs for inflation. At the beginning of the last negotiations in September 2016 health minister Marisol Touraine introduced a new legal procedure, the Arbitrary Judgment, which came into force if the Dentists failed to agree to the NHI's propositions. These propositions included setting caps on most of the previously unregulated dental prosthetics and a global price ceiling on the whole dental market. This sparked a nationwide strike of the profession, a blockade of all 16 Dental Schools and several national protests. This movement raised nationwide debates regarding the access to dental treatments, preventive care and out of pocket payments for patients. The political tensions generated between the stakeholders, as well as the lack of both robust epidemiological and economic data challenges the ability of this policy making process to produce comprehensive, evidence based and economically sustainable reforms.

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