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French PM Prescribes Tax for No-Shows at Doctor's Appointments

Posted on Feb. 6, 2024

France’s new prime minister, Gabriel Attal, has proposed a headache relief prescription specifically for healthcare providers — a tax on patients who don’t show up for their doctor’s appointments.

French media have branded it taxe lapin (the rabbit tax) from the phrase taxe poser un lapin (setting down a rabbit), which describes a situation in which a person doesn’t show up for an appointment or meeting without advance notice.

In January 2023 France's National Academy of Medicine and National Order of Physicians estimated that about 27 million medical appointments per year are missed by no-shows.

“This phenomenon seriously disrupts the daily work of private practitioners and hospital consultations, reduces the medical availability of the practitioners affected, limits access to care for patients who really need it, and contributes to increasing the number of patients who turn to emergency services,” the groups said in a joint statement.

“We are going to make those who don’t show up at medical appointments without warning pay,” Attal, who took office in January, said in his general policy speech January 30. He said it is unbearable for patients who wait months to get an appointment to learn that millions of hours are wasted because of no-shows.

“Healthcare is not free,” newly appointed Minister for Labor and Health Catherine Vautrin said in a February 3 article in regional newspaper L’union-L’Ardennais. She said a levy on no-shows would make citizens more responsible.

Access to medical appointments is especially problematic in France because it capped the number of medical students who could access the second year of study between 1971 and 2021, leading to a sharp decrease in the number of doctors. In a May 2023 release, the French Directorate for Research, Studies, Evaluation, and Statistics said two-thirds of general practitioners in 2022 said they could not accept new patients.

The government rejected a Senate proposal in the 2023 Social Security financing bill that would have introduced a fee collectible by the state-run public health insurance program that could be shared with doctors because of no-shows. The government before the 2024 reshuffle said it had not found the right formula for a levy that would ensure equal treatment for all patients, regardless of how they booked their appointments (through an internet platform or by other means).

The French newspaper Le Figaro pointed out in a January 31 article that the public health code says doctors’ fees can be claimed only for services that were actually performed.

In any case, Attal promised a solution in 2024.

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