Selon les derniers chiffres, les complémentaires assument actuellement 72 % de la dépense de santé en optique (4 % sont pris en charge par la Sécurité sociale, 24 % par le patient), 45 % de la dépense sur les prothèses dentaires (20 % par la Sécurité sociale, 35 % par le patient) et 29 % pour les audioprothèses (14 % par la Sécurité sociale, 57 % par le patient).
Pour atteindre l’objectif de 0 % pris en charge par le patient, la FNMF suggère de contractualiser des « paniers de soins nécessaires et de qualité » sans aucun reste à charge pour les patients, directement avec les acteurs concernés (opticiens, dentistes et audioprothésistes). Ces contrats pourraient ensuite être renégociés régulièrement afin d’y intégrer les innovations. Le patient pourrait accéder librement à des équipements supplémentaires, les professionnels pouvant proposer des options.
Pour mettre en place ces principes au meilleur coût, la Mutualité propose plusieurs modifications des filières concernées. Par exemple, concernant l’optique, pour limiter le nombre de praticiens qui pèse sur les coûts de distribution, il faudrait allonger la formation initiale, de 2 à 3 ans, limiter le nombre de places et renforcer les compétences en optométrie. Une baisse de la TVA de 20 % (taux normal) à 5,5 % (taux réduit) sur les verres pourrait aussi accélérer les baisses de tarifs. Pour les audioprothésistes, la Mutualité propose de réviser la nomenclature pour mieux définir les classes d’équipement en les adaptant aux déficits auditifs. En dentaire, la FNMF préconise une revalorisation des soins conservateurs et une modération des tarifs des soins prothétiques.
Elle propose enfin de mettre en place un observatoire pour suivre l’évolution du reste à charge et des tarifs dans les secteurs de l’optique, du dentaire et de l’audioprothèse.
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