Back to 39 hours in the hospital, funded retirement… the shock proposals of the Institute of Social Protection for the presidential election

Blow ideas into the ears of presidential candidates. The Social Protection Institute (IPS) has just issued a list of proposals to highlight the changes to be made for our social protection system. The red thread of these suggestions is to offer more freedom to the French in the choice of their coverage for their retirement, for their health but also to alert them to the financial preparation for a possible loss of autonomy as they age.

The crisis has shed even more light on the structural problems facing hospitals. The IPS notes in particular that “more than a third of the jobs within the hospital are devoted to administration, ie 25% more than in other developed countries”. He encourages a reinstatement of the system by asking for the return to 39 hours for the staff accepting it with a high salary increase, to return to third-party payment “because patients no longer have any awareness of the generosity of the health system. ”. The idea would also be to establish a hierarchy of care by distinguishing essential care for which coverage would remain at 100%, from others which would remain the responsibility of the insured or covered under a contract. complementary.

Replace part of social security contributions with micro-levies

Another point on which the IPS relies: social security contributions. Those that you pay for retirement, for example, allow you to acquire rights. But according to the IPS, contributions always bring less benefit to those who pay them. Let’s take the example of retirement, you contribute at the same level but you get fewer and fewer rights for your future retirement. To prevent this slide from continuing, the Institute puts forward the original idea of ​​replacing part of the social security contributions with micro-levies on all payments. “This solution, advocated by some economists, has never been seriously studied”, regrets the IPS which invites candidates to commit to asking the Ministry of Finance, under the aegis of Parliament, to assess the feasibility and the relevance of such a mechanism.

Raise the retirement age and include a dose of capitalization

The major reform creating a universal pension scheme and promised by candidate Emmanuel Macron in 2017 has not seen the light of day. It was stopped mid-flight in March 2020 due to the pandemic. Since then, it has been put away forever. The President of the Republic no longer speaks of a universal scheme but of three distinct blocks for private sector employees, civil servants and the self-employed. Good news according to the IPS, which is campaigning for a basic universal pension and for separate supplementary schemes according to the statutes. But the reform to be carried out as a priority is the postponement of the retirement age which “could even be established at 65 in order to finance the needs related to dependency, estimated at 9 billion euros per year”, detail the report.

The IPS also calls for a review of the rules for cumulating employment with retirement by allowing it to open up new pension rights (but with a number of points twice lower than that of a non-retired contributor), which is not the case today, and to open the survivor’s pension to PACS couples. The Institute is also initiating the debate on funded retirement by proposing to integrate a dose of collective funding into compulsory schemes to guarantee the purchasing power of retirees. Proceeding cautiously, he suggests looking at already existing capitalization systems such as the additional public service scheme (RAFP) and the complementary scheme for pharmacists (CAVP).

Anticipating long-term care financing

The reports commissioned on the subject of old age and loss of autonomy agree that by 2030, 9 billion euros will be needed per year to take care of the elderly. If it is planned that part of the Generalized Social Contribution (CSG) be reserved for the 5th branch of Social Security for autonomy, which represents more than two billion per year, the amount may be insufficient. The IPS proposes to use part of the invalidity guarantee for financing. You may not know it, but your employer contributes to pay you benefits if you become disabled. When you retire, you lose this guarantee. It would then be a question of proposing in this invalidity guarantee a dependency or caregiver option “to smooth out the costs”. And when you retire, this guarantee would only cover dependency.

Encourage innovation in complementary health insurance

As for the universal pension scheme, the IPS considers the idea of ​​a large Secu which would see the role of mutuals diminish considerably, totally obsolete. On the contrary, the Institute believes that complementary health insurance has demonstrated a strong capacity for innovation during the pandemic, for example by contributing to the development of telemedicine. A movement that should be encouraged, for example, by partially or totally exempting from the additional solidarity tax (TSA), which makes it possible to finance, in particular, aid for the acquisition of complementary health insurance (ACS), organizations which devote a percentage given to prevention and innovation.