Projet {R3}
PRIORITY FILE

Health

I. ASSESSMENT

A System of Excellence on the Verge of Asphyxiation

Our health system, long considered one of the best in the world, is running out of steam. Staff exhaustion, deterioration of access to care and a structural financial crisis are no longer weak signals, but symptoms of a hyper-centralized organization which is no longer in tune with the needs of the country.

The Hemorrhage of Talent: The Demobilizing Competition of Neighbors

This internal crisis is massively aggravated by the attractiveness of our neighbors. For border regions, competition from Switzerland, Belgium and Luxembourg is not a theory, it is a daily hemorrhage. More than4,500 doctorstrained in France are already working abroad, attracted by objectively better conditions.

More agile decentralized systems:

These countries share largely decentralized health systems. In Switzerland, the cantons are responsible for basic care and hospital planning. In Belgium, it is the Communities that pilot health policies. This local governance gives them an agility and a capacity for adaptation that our Jacobin system has lost.

II. THE SOLUTION {R3}

The Federal Solution: A tailor-made and competitive health policy

Faced with this observation, federalism is not an option, it is a necessity. It is about giving territories the levers to care for their inhabitants and to become attractive again.

A “Regional Ministry of Health”:

To replace the ARS, a real elected regional ministry would be created. He would have full responsibility for health policy: hospital card, community medicine, prevention, training of paramedical professions, etc.

How the Region can become Competitive again:

  1. Implement an attractive salary policy: A region like Alsace or Dauphiné-Lyonnais, in direct competition with Switzerland, would have the freedom to vote for additional remuneration for its caregivers in order to align with neighboring salary levels and stop the bleeding.
  2. Improve working conditions: By controlling its budget, the Region could invest massively in recruitment to increase the ratios of caregivers per patient, finance cutting-edge equipment and modernize hospitals.
  3. Fight against medical deserts through innovation: The Region could experiment with agile and adapted solutions: creation of regional health centers with employed doctors, study grants in return for an installation for several years, or even the development of telemedicine linked to local "digital buses".
  4. Simplify and empower: The Region, in conjunction with its “Bercy des Territoires”, could reduce the administrative burden on health professionals and give them greater autonomy in the organization of care.

The Role of the Federal State:

The Federation would guarantee the “Republican Base of Access to Care” (the principle of universal health insurance, financed by the national solidarity tax) and would remain the strategic pilot in the face of major health crises (pandemics, management of essential medicines).

By entrusting health to the Regions, we are betting on responsibility and intelligence on the ground to rebuild a fair, effective and attractive healthcare system.