After the tripartite, the quadripartite: the situation of the health and maternity insurance at the heart of the debate



The quadripartite committee meets twice a year to take stock of the financial situation of the health and maternity insurance scheme (AMM).

The budget for the AMM is based on estimates of GDP, the employment rate and the contribution base of those insured for health care. At present, expenditure on health care and cash benefits for health and maternity is growing faster than income, a trend that has become more pronounced in recent years. Since 2020, the current operations have resulted in a negative result, which means that the reserve has to be drawn on.

In view of the structural expenditure and other uncertain external factors, such as the current economic and health context, it is difficult to envisage an improvement in the AMM’s financial situation. In addition, future discussions within the Gesondheetsdësch and new benefits that will further impact the AMM’s financial situation must be taken into account.

In the medium term, if the dynamics of expenditure are not curbed, the AMM should therefore be stuck in a recurrent deficit of around EUR 100 million per year. While the IGSS report on the AMM’s financial situation, dated October 2021, calls for caution on all actions that aim at a structural change, even minor, of the AMM’s organisation.

Therefore, the challenges for the AMM are multiple and UEL reiterates its recommendation for a responsible and integrated approach, a coherent management of the health system by favouring certain paths. For example: digitalisation, the pooling of certain services and competences, the fight against systematic abuse and fraud, with a view to improving and guaranteeing sustainable services for insured persons and patients.

Finally, it is in the interest of all stakeholders to preserve the sustainability of our AMM system in order to maintain access to health care for insured persons through coordinated planning in the hospital/extra-hospital/ambulatory field. But also to avoid any increase in contributions which would hardly contribute to an improvement of the system, but only to slow down in the short term the scissors effect between the expenses and the revenues of the AMM.