“What is totally abnormal and even revolting is that there are people (…) who are on sick leave even though they are not sick,” declared Bruno Le Maire in June 2023. Modify the conditions of Compensation for sick leave is already a key issue for the government. The latest report from the Court of Auditors will therefore not displease the executive. Published on May 29, 2024, this text recommends drastic measures aimed at reducing the deficit of the National Health Insurance Fund (CNAM), and fighting against “fraud”. These would make it possible to achieve between “500 million and 1 billion euros” in savings.
The amount of daily allowances (IJ) paid to salaried and self-employed workers on sick leave reached 12 billion euros in 2022, or 1.96% of the total amount of health insurance expenditure (610.7 billion this year -there).
This limited portion tends to gain weight. Expenditure linked to IJ has in fact increased by 4.3 billion euros compared to 2017, figures from the Court of Auditors. The level of this expenditure particularly increased during the period of health crisis when the French were forced to stay at home in the event of contracting Covid-19, and even in the event of suspected symptoms. An emergency law then removed the waiting period, which corresponds to the period (3 days in the private sector) during which employees on leave do not receive daily compensation.
At the end of the crisis, expenses linked to daily allowances fell before starting to rise again in 2022 (19%), then reducing again in 2023. Excluding expenses linked to Covid, the total amount of daily allowances paid however, continued to increase (6.2%), according to Health Insurance. The organization mainly attributed this increase to the revaluation of the minimum wage, of 4.3%. As the calculation of daily allowances is based on the salary during the months preceding the stoppage, any increase in this automatically leads to an increase in the allowances paid.
Another cause given to explain these increases in expenditure: the aging of the compensated population. Regarding the reasons for arrest, psychological disorders come first, with 3 million arrests in 2022 (according to Le Monde citing figures from the Cnam).
The other objective in the viewfinder concerns “fraud”. In the text of the wise men of rue Cambon it represented in 2022 some 12.8 million euros (i.e. a level recognized as “low” in relation to total expenditure). The definition of this term is not specified. In the text of the report, there is particular mention of “false” work stoppages – due to identity theft, these extremely rare cases – which would be made impossible thanks to the generalization of teletransmissions of work stoppages by caregivers authorized to issue them. There is no question of so-called “convenience” judgments which would be attributed to people “not really sick”.
In a press release issued on May 30, the Court of Auditors, however, mentions these famous “prescriptions of convenience”. It specifies to formulate its recommendation: “in order to reduce health insurance expenses, modify the parameters of compensation for work stoppages, in particular with a view to better distributing the burden between social security, companies and policyholders, following consultation with the social partners.
Concretely, the recommended measures consist of eliminating compensation for work stoppages if they last less than 8 days, and of extending the waiting period from 3 to 7 days. There would remain “one day of public order deficiency”, that is to say that companies would not even be able to compensate for this day not worked, therefore remaining entirely the responsibility of the employee. This last measure was already recommended by the Court of Auditors in 2019. This was to serve as “an additional signal in favor of controlling the frequency of work stoppages
The case of compensation covering long periods is also mentioned. Although rarer, they are nevertheless those that weigh the most on public accounts. “Stoppages of more than six months, which represent only 6% of the number of stoppages compensated, lead to almost half of the expenditure on non-Covid compensation”, it is noted in the report. The authors propose to question the maximum duration of compensation “unchanged since 1945”. Based on work by Social Security, they propose to reduce the maximum duration of continuous compensation from 3 to 2 years, with exceptions for certain pathologies.
Finally, the Court of Auditors wishes to reduce the amount of IJ paid in the event of a judgment. It proposes “a reduction of five points in this rate, to 45% instead of 50% of gross salary”, in order to reduce its expenses to a level equivalent to the savings made by companies (1 billion euros envisaged) in the event of increasing the waiting period and establishing a “public order” deficiency.