Sickness insurance scheme RCAM

02 March 2023

USi has sent another letter addressed to the Italian Ministries of Health and of Foreign affairs, this time in collaboration with the sister branches of the Union Syndicale Fédérale of Florence (IUE) and Turin (ETS), always in support of European Civil servants' access to national healthcare in Italy.

17 February 2023
See here two letters issued by USI in close collaboration with Laywer Michela Velardo, in support of European Civil servants' access to national healthcare in Italy:

The first is addressed to the Parma Local Health Authority (AUSL) at the end of January 2023, concerning the unacceptable requirement for EFSA staff to renew their heath card on a monthly basis.
The second has been sent to the attention of the Italian Minister of Health in mid-February 2023.

Per agevolare i colleghi ai quali non è stata ridata la tessera sanitaria dal competente ufficio territoriale del SSN, USI mette a disposizione un modello di procura per conferire mandato all’Avvocato Michela Velardo.

La procura compilata e firmata va inviata alla segreteria USI (jrc-usi-ispra@ec.europa.eu), specificando il servizio socio sanitario competente e allegando copia di un documento di identità.

Il servizio è gratuito per gli iscritti USI, con un contributo spese di 25 euro per i non affiliati:

Troverete il modello di procura al link qui

In order to facilitate colleagues to whom the health card has not been given back by the competent territorial office of the Italian National Health Service (SSN), USI is providing a power of attorney template to confer a mandate to lawyer Michela Velardo.

The completed and signed power of attorney form must be sent to the USI secretariat (jrc-usi-ispra@ec.europa.eu), specifying the competent health service and attaching a copy of an identity document.

The service is free of charge for USI members, with a fee of €25 for non-members.

Please find the power of attorney template here

RCAM: l’USF demande une concertation interinstitutionnelle

26 Octobre 2017

Dans une lettre ouverte adressée à toutes les DGHR des institutions européennes, l’USF demande l’ouverture d’une concertation interinstitutionnelle concernant le Régime Commun d’Assurance Maladie (RCAM) sur les points suivant:

Depuis 2007, les plafonds qui limitent le remboursement n’ont pas été actualisés et sont sous-estimés par rapport aux frais réels engendrés. Nous demandons l’introduction d’un système de mise à jour des plafonds lié à l’évolution des prix des prestations du marché belge.
Le CGAM doit devenir un vrai comité de gestion, rendant des avis contraignants. Ses membres doivent avoir accès aux données nécessaires pour en assurer le bon fonctionnement.
Les restrictions arbitraires mises en œuvre par les bureaux liquidateurs doivent cesser. Notamment, il faut revenir à une définition humaine de la maladie grave: tout traitement vital doit être remboursé à 100 %.
Pour les prestations en dehors de la Belgique, il est nécessaire de réviser la méthode de calcul des coefficients d’égalité dans le but d’assurer un traitement égal c’est-à-dire un remboursement réel de 85% des dépenses déclarées.
La Commission doit veiller à ce que la DIRECTIVE 2011/24/UE du 9 mars 2011 relative à l’application des droits des patients en matière de soins de santé transfrontaliers soit respectée par les États membres, qui doivent garantir que les prestataires de soins de santé appliquent, sur leur territoire, et aux bénéficiaires du RCAM, le même barème d’honoraires de soins de santé que pour des patients nationaux se trouvant dans une situation médicale comparable.
Nous demandons de prendre toutes les mesures nécessaires pour arriver à une reconnaissance de la « prise en charge » avec les hôpitaux dans chaque État membre.
Le régime d’assurance maladie doit renforcer, dans un intérêt mutuel, ses programmes de prévention, y compris pour les enfants à charge. Nous demandons donc l’insertion dans le programme de médecine préventive: des examens pédiatriques, psychologiques, du suivi de grossesse, les vaccinations recommandées par les autorités nationales
Nous demandons la révision des règles concernant la prise en charge des thérapies psychologiques qui actuellement sont excessivement restrictives.

la demande d'ouverture d'une concertation interinstitutionnelle concernant le RCAM envoyée aux chefs d'administration des institutions européennes le 26 Octobre 2017

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THE SICKNESS INSURANCE SCHEME: A STATE OF PLAY?

A spectacular recovery

RCAM : Act to preserve Solidarity

1) Solidarity Regime

everybody is contributing according to its resources
Each is served according to its needs
The employer bears 2/3 of the cost

It's essential to preserve these characteristics, The resulting solidarity has three dimensions

High wages with low wages
Young people with old people
affiliates having dependents with the isolated

2) Regime trends

The population covered by the scheme is growing steadily, currently at an annual rate of 3.5%, In 8 years, the population growth reached almost 60%
The average age of affiliates has increased since 2009, lastly 6 months per year. It now reaches 50.6 years
The expenditures of the regime evolve in a normal way, at the same rate as the population and the prices
The income of the system grows less rapidly than the population, even in nominal terms. The wage freeze since 2009 is the responsible. This produces a sustainable operational deficit.
The actual reimbursement rate - ratio between the total benefits of the scheme and the costs actually incurred by the beneficiaries - is decreasing. Actual prices paid are increasingly exceeding the plan ceilings, unchanged since 2008. This undermines the principles of solidarity of the regime, and puts a growing part of the costs on the back of the staff, for the benefit of the employers.
The BLs (Bureau Liquidateur) are under staffed. To maintain a constant quality of services, these staff should grow proportionally to the number of beneficiaries. However, it is constant and will be down (cutting 5% of staff)
under staffed. To maintain a constant quality of services, these staff should grow proportionally to the number of beneficiaries. However, it is constant and will be down (cutting 5% of staff)

The result of these trends is under funding of the scheme. For the time being limited, it is likely to widen rapidly.

The BLs react by tightening the screw, in the margin of regulation: Refusal of reimbursement under various pretexts (eg lack of tax receipt), refusal of psychological treatment, refusal of recognition of serious illnesses, cuts in preventive medicine

3) Perspectives

The average age will continue to grow. This increase will be further amplified by the non-replacement of retirements as part of the reduction of 5%. As a result, expenses per affiliate will increase faster than inflation
The continuous wage freeze - 2013, 2014 - will amplify the annual deficit, unrecoverable without changing the parameters of the system
In the medium term, the reduction in the average speed of promotions (blockages in AST9, AD12, reduced speed of the AST/ SC career) will increase the deficit
The average contribution of affiliates will tend to decrease: The average salary of secretaries and clerks will be much lower; Recruitment in AST3 will be replaced by AST1; The pensions in the future will be 25% lower than the current level.

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