PRESS RELEASE
05 October 2021
PUBLIC FINANCES AND ACCOUNTS: SOCIAL SECURITY
REPORT ON THE IMPLEMENTATION OF THE
SOCIAL SECURITY FINANCE ACT
In 2020, the Covid-19 pandemic led to the highest social security deficit ever recorded,
representing 1.7 points of GDP. Close to break-even point in 2019 and after suffering a
deficit of unprecedented magnitude in 2020 (-
€39.7 billion), the mandatory basic social
security schemes and the Old-Age Solidarity Fund (FSV) will again see a major financial
imbalance in 2021 (-
€34.8 billion in forecast deficit). Beyond 2021, the development outlook
appended to the 2022 draft social security finance act includes a deficit in social security as
a whole of around €15 billion by 2024.
As of now, it is certain that the cap of €92 billion for authorising the reversal of deficits by
the social security debt repayment fund (CADES) for 2020 to 2023, set by the law of 7 August
2020, will not cover the 2023 deficit.
To preserve this essential link of cohesion and solidarity, it is necessary, once the crisis is
over, to initiate a path of return to financial equilibrium in our social security system, with
the goal, as a first step, of limiting the increase in social debt, then starting to gradually
reduce it. The Court has made 44 recommendations to achieve this.
Curb social security expenditure and indebtedness
The functioning of social security should be based on the principle of not financing through
borrowing
–
and therefore passing on to future generations
–
the coverage of today
’
s social
risks. Returning the accounts to a break-even point is therefore key to the proper
management of social finances; this means initiating resolute actions to seek expenditure
efficiency, particularly in health insurance and pensions. Given the very high level of
compulsory levies in France, increasing them cannot be an option.
The Court recommends, firstly, improving the social security finance acts, notably by requiring
the Government to submit, during the financial year, a supplementary act if there is
substantial doubt regarding the forecasts of results approved the previous autumn, as is the
case with the central government budget. Secondly, because of the lasting significance of the
measures decided under the
“
Ségur de la santé
”
agreements, the Court considers it necessary
to use all the levers for action affecting health expenditure, while ensuring the greater
relevance and quality of care and combating health inequalities.
Exiting crisis management methods
The social security agencies have had to contend with a pandemic unprecedented in its scale
and scope. They have succeeded in ensuring the continuity of their activities, particularly in
avoiding any disruption in the payment of social benefits, by adapting their organisation,
working remotely en masse and simplifying the usual management rules and procedures.
Through three inquiries, the Court has drawn up an initial assessment of the management of
social security during the pandemic. From the payment of benefits to the recovery of social
security contributions, the easier use of telehealth tools and the temporary suspension of the
regulation on expenditure in medical biology, the measures implemented have come in
response to emergency situations. They cannot continue once the pandemic is over. The
imperatives of recovery and audit are now the key challenge for the social security agencies.
Relaunch and accelerate the management reform and improvement projects
The pandemic has slowed down the progress of numerous management reform and
modernisation projects, which are nevertheless essential for redressing the financial situation
of social security and meeting the
population’s
needs over the long term. These challenges
are illustrated in the report through four priorities:
-
accelerate the adaptation of funding methods for healthcare agencies and medical-
social agencies and services;
-
complete the digitisation of medical prescriptions, an area in which France is lagging
far behind compared to the United Kingdom, Belgium, Spain and Italy;
-
modernise the mechanism for recognising and compensating work accidents and
occupational illnesses: the AT-MP branch must, in particular, redirect its priorities to
actions that foster the return to work of employees on leave, who are at risk of reduced
employability;
-
improve
the efficiency of two solidarity allowances: the basic old-age pension or the
solidarity allowance for the elderly (ASPA), the very complex allocation rules of which
deserve to be simplified, and the back-to-school allowance, the benefit of which could
be refocused on families on the lowest incomes, and the scale adjusted to more
effectively cover the escalation of expenditure linked to schooling according to
children’s
age.
Read the report
PRESS CONTACT:
Emmanuel Kessler
Communication Director
Tel.
01 42 98 55 62
emmanuel.kessler@ccomptes.fr
Julie Poissier
Head of press relations
Tel. 01 42 98 97 43
julie.poissier@ccomptes.fr
@Courdescomptes
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