Ensuring a sustainable healthcare system

On 8 November, UEL took part in the quadripartite committee as the employers’ representative.

The quadripartite committee met on 8 November to examine the financial situation of the sickness-maternity insurance (AMM) and its evolution for 2024. The UEL represents the employer-contributors.

Based on estimates drawn up by STATEC in September, current expenditure is projected to rise by 7.8% in 2023 and 2024. Current receipts are projected to rise by 9.6% in 2023 and 6.0% in 2024. As current revenue is estimated to exceed current expenditure in 2023, a positive current account balance of around 24.9 million EUR is expected. This positive balance is mainly due to the application of 3 index tranches and the postponement of the valuation of the key letter for doctors and dentists. In 2024, the balance of current operations will again be negative, amounting to -51.9 million EUR. This clearly reflects the volatile nature of AMM revenues. The reserve should fall below the legal threshold (10% of total expenditure) in 2027.

UEL recalled the uncertain geopolitical context and STATEC’s recent macro-economic estimates – more pessimistic than those used to establish revenue and expenditure projections – pointing to a recession in 2023. This context could have a direct impact on AMM revenues, which are dependent on strong economic growth and employment. To ensure the sustainability of the healthcare system and avoid any increase in social security contributions, an analysis of revenue and expenditure is necessary. An increase in contributions would have a negative impact on the attractiveness of Luxembourg and therefore reduce economic activity and employment. Businesses and employees would see their costs rise without any improvement in health services.

UEL is also concerned about the increase in absenteeism, which according to the IGSS will rise to 5.2% in 2022, compared with 3.6% in 2017. This rise in absenteeism has a financial and human cost. For a more complete and accurate understanding of the occupational health situation in Luxembourg, and with a view to reducing absenteeism and managing prevention, it is necessary to have an anonymised and exhaustive health database, taking into account the entire working population (private and public sectors), residents and cross-border commuters, and the medical reasons for absences.

Finally, UEL reiterated the importance of digitisation in the healthcare sector too. In order to move forward as quickly as possible, a coherent and coordinated strategy with a ‘lead manager’ is needed to ensure an effective digital transition in the healthcare sector in the interests of all stakeholders.