The AME reform wanted by Bruno Retailleau is “completely stupid” according to caregivers

The Minister of the Interior talks about reforming emergency medical aid. Former Ministers of Health and many doctors denounce a nonsense that will not allow savings to be made.

&Just a few days after joining the government, Bruno Retailleau has announced his intentions: he wants to reform AME. State medical aid allows people in an irregular situation in France to have access to care under certain conditions. This aid is not appreciated by part of the right and the far right, who consider that it makes France attractive, thus attracting more immigration. The Minister of the Interior also declared on TF1 on September 23: “We have a problem, which is that we are one of the European countries that gives the most advantages and I do not want France to stand out, for France to be the most attractive country in Europe for a certain number of social benefits for access to care.”

A statement that has made the health world jump, which considers a possible reform of the AME as dangerous for public health and counterproductive on the subject of illegal immigration. Eight former health ministers gathered behind a platform in Le Monde to “recall the importance of maintaining state medical aid”. Concerning the attractiveness of France for people wishing to migrate to Europe, they are unanimous: “This is a fantasy contrary to the facts, again clearly established in two solid reports drawn up in 2019 and 2023”, adding that “AME does not concern comfort care, likely to attract immigration whose causes are obviously more diverse and complex.”

The world of healthcare is also up in arms after this statement by the Minister of the Interior. Philippe Froguel, a doctor and teacher-researcher, speaks of a “moral shipwreck” and a “health time bomb”. For his part, Anthony Gonáccedil;alves believes that such a measure would aim to flatter the RN electorate: “The French have mobilized to refuse the RN in power and find themselves this morning with a “Bruno Mágretá with small feet who wants to attack the SOUL in contempt of healthá public and all medical ethics.”

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Removing AME would be more expensive than maintaining it

Behind Bruno Retailleau's proposal, there is also a notion of economy. By reducing the scope of action of AME, transforming it into emergency medical aid, the goal is to reduce the budget of Social Security. However, according to Aurélien Rousseau, Roselyne Bachelot, François Braun, Agnès Buzyn, Agnès Firmin Le Bodo, Marisol Touraine, Frédéric Valletoux and Olivier Véran, the signatories of the platform, this will not work: "Weakening AME means exposing our health system to increased pressure from later and therefore more serious and more costly care." AME represents an expenditure of 1.2 billion euros per year, or about 0.5% of health expenditure provided for in the Sécu budget. Last year, there were 466,000 AME beneficiaries.

A danger to public health

The eight former ministers finally warn of the risks that a removal, or a reduction, of the AME would represent for public health. They explain that financially preventing a person from consulting a general practitioner for a pathology would only delay their care, pushing them to go to the emergency room with a more serious health concern: “The care of a beneficiary costs seven times more than hospital than in community medicine.” They are also worried about the risk of an epidemic that this could represent, while the world is still traumatized by the Covid-19 pandemic. “Concretely, weakening the AME means disinvesting in the field of prevention, whether it is vaccination or screening. In fact, such a step backwards creates a risk to the public health of all our fellow citizens, particularly infectious ones,” comment the ministers, who also warn about medical ethics. As the National Council of the Order of Physicians recalls, the Hippocratic oath, taken by all doctors before practicing, says: “I will respect all people, their autonomy and their will, without any discrimination according to their “condition or their convictions”, “I will give my care to the indigent and to “whoever asks me for them.” Furthermore, the Declaration of Geneva, annexed to the Code of Medical Ethics and adopted by the General Assembly of the World Medical Association in 1948, states: “I WILL NOT PERMIT that considerations of age, disease or infirmity, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social status or any other factor come between my duty and my patient.”