The project for the generalization of social coverage, initiated by King Mohammed VI, could only see the light of day in due form with the involvement of all the actors concerned, in particular health professionals, the private sectors and audience.
Even if the unions of liberal doctors were able to reach an agreement after a close tussle with the guardianship and the National Social Security Fund (CNSS), some professionals still do not agree with the conditions for joining the Compulsory health insurance (AMO) and the contribution rates imposed on doctors which remain too high, according to them.
April 2022, the Ministry of Health, the CNSS and the white coat unions were able to reach an agreement for medical coverage “ fair and equitable with incentives“. But it will be necessary to wait for the start of the construction site of the generalization of social security to model the incentive measures promised to liberal doctors and to identify their nature.
The minutes signed in November 2020 between the Order of Physicians (CNOM), the Ministry of Health and the Ministry of Labor had recorded a lower annual contribution on the basis of a flat rate of 4x SMIG for general practitioners and dentists and 5.5 x SMIG for specialists plus incentives. The latter suddenly disappeared from decree n° 2.21.529 adopted by the government, which stirred up the wrath of doctors.
After the rejection of this decree by the unions, a dialogue was opened between the union representatives of the liberal medical sector, the Ministry of Health, the National Health Insurance Agency (ANAM), and the CNSS, which led the holding of several meetings at the end of March 2022 on the new methodology for agreements with healthcare providers and the incentive measures for healthcare professionals within the framework of AMO (compulsory health insurance).
But the category of doctors who are still in disagreement with this decree, wonder when these incentive measures, promised by the guardianship in 2020 already, will see the light of day.
Joined by MoroccoLatestNews UK regarding the frustration of some doctors with the AMO arrangements, Dr Tayeb Hamdi, president of the National Union of General Practitioners (SNMG), recalled that the unions, when there was no dialogue with the supervision and the organizations concerned, have called on doctors to moderate in registration while waiting to find solutions, while they were aware that the law is applied for all, and the contributions imposed on doctors by law, whether they pay or no, will be cumulated, in addition to penalty.
” We declared to assume the penalties for late payment of contributions to the CNSS, in order to give a signal of protest to the guardianship, and that there must be a dialogue before applying things. So there was a dialogue with the Ministry of Health. We agreed on several points, in particular the incentive measures. And so we called on doctors to register with the CNSS“, he clarified.
For the trade unions in the sector, Dr. Tayeb affirms that “ all doctors in the liberal sector are called upon to contribute in order to benefit from social and medical cover. Otherwise, by delaying the process, they will only pay more penalties “.
As for this fringe of doctors who do not agree with the percentages and who are afraid that the ministry will not respond to the demands, as usual, in particular these incentive measures, Dr. Hamdi refers to it “ to the implementing decrees for the generalization of social coverage, which have been published, and the law which has entered into force and which must be applied and respected“.
” As unions, we contested the contribution rate on a number of criteria, in particular the injustice we suffered in comparison with other professions. But in the end, we decided to join the project. In any case, health professionals, normally and conventionally, must have the incentives promised by the guardianship“, he promised.
That said, these incentives do not appear in the law and decree of the generalization of the AMO, underlines Dr. Hamdi, before specifying that they will be present during the renewal of the convention.
” We are in the process of negotiating for the renewal of the national conventions. And this is where we mention incentives. For example, a doctor in his office will prescribe 50% generics, etc. So the doctors are committed to points, and so are the sickness funds. For example, on a chronic illness, the funds undertake to pay us a fixed amount of so much per year, and assume with us 50% of the social charges, etc. All this appears in the negotiations of the national convention and not in the law“, specifies the trade unionist.
For the national convention, it was made in 2006 reminds us of Dr. Hamdi, then renewed in 2009. But the renewal never took place, he laments.
” On January 13, 2020, we signed an agreement with the CNSS, but the CNOPS abstained. And yet, several points have not been applied since, due to the Covid-19 which appeared and other problems. But today, we are in a new phase of health insurance. We are in the process of renegotiating a new agreement that we are discussing with the Ministry of Health and ANAM with a new vision as part of the overhaul of the health system.“, he concluded.