The head of the association representing Luxembourg’s doctors and dentists has said it is likely that it will officially terminate its convention with national health insurer CNS later this week, amid a row over the future direction and funding of the healthcare system.
The AMMD (Association des Médecins et Médecins-Dentistes) had voted to withdraw from the agreement earlier this month, and the association’s president, Chris Roller, told the Luxemburger Wort there had been no significant progress in negotiations in the weeks since.
“The problems are still there. There is still no overall concept. Instead, the discussions are trying to cover individual problems with a patchwork of measures,” he said.
The AMMD is calling on the government to act on promises made in the 2023 coalition agreement between the CSV and DP, in which the two parties pledged to unveil reforms to the healthcare system. The CNS’s financial reserves are likely to fall below the legal requirement as early as 2027 and some fear that they could be completely exhausted by the end of 2028.
Why doctors are threatening to cancel agreement with CNS
“We are only calling for the political promises to be implemented. To do this, the legal framework must be adapted – this can only be done in dialogue with Minister Martine Deprez and the CNS,” he said.
As soon as the convention has been formally cancelled, the CNS must enter into negotiations with the AMMD within two months, and if there is still no agreement after a year of talks, the country’s health minister can impose new regulations for the sector through a Grand Ducal regulation. Roller described such a scenario as “legally absurd”.
“By definition, a convention is a voluntary agreement between two parties. Enforcing it in this way is legally absurd,” he said, adding that the association would consider legal action if the situation arose.
However, the AMMD president dismissed concerns that the CNS would stop reimbursing medical services in the event of prolonged negotiations and legal dispute. The contributions would continue to flow and the obligation to reimburse costs would therefore remain in place, Roller argued. “I see no reason to panic. The CNS will still have to pay – it’s the contributors’ money, not their own,” he said.
Core demands
The AMMD wants to put several points on the table as part of the negotiations, which include adjusting fees, strengthening outpatient services and reducing red tape. “Medical progress is currently being hampered. New procedures or technologies often take ten years to be covered by charges. This is not justifiable for patients,” said Roller. “Patients then go abroad and may be reimbursed for these services there.”
The existing system is also economically inefficient, the AMMD president claimed. “Hospitals sometimes function like a black box. The CNS often doesn’t even know exactly what it is paying for,” said Roller.
(This article was originally published by the Luxemburger Wort. Machine translated, with editing and adaptation by John Monaghan.)
