Interview Maryse Médina

What does the CNAMTS have to offer in the area of cooperation?

Providing 85% of the population with a very broad scope of coverage, including sickness, maternity and industrial injury benefits, the CNAMTS is a cornerstone of France’s health insurance system. This is an obvious asset in the area cooperation, as foreign countries and institutions most often require help in a broad range of fields ranging from the administration of benefits and negotiations with health-sector professionals to relations with health care institutions and beneficiaries. Another distinctive feature of the CNAMTS is a dual emphasis on technology and the medicalised control of costs. On the technology front this means the development of information systems, the system of managing reimbursements, the health insurance smartcard, etc., and in terms of medicalised control, the introduction of patient pathways, preventive health care, quality of care, official schedules of medical procedures, continuing training for health professionals, etc. These two aspects are incidentally the two main themes of international cooperation in the area of health insurance.

What is the nature of CNAMTS’s cooperation work?

Let me give you some examples which should provide some idea of how we work. Further to various needs expressed by Morocco during talks in France with the French President and the Managing Director of CNAMTS, the latter conducted a scoping mission in partnership with the GIP. This culminated in the signing of a cooperation agreement by the French and Moroccan ministers and the appointment of a project manager. Under the auspices of this agreement, CNAMTS participates in various initiatives like the creation of a medical inspection service involving an in-country mission by a French regional medical advisor. We also provide in-country training as well as placements for trainees in our own medical inspection service. And we also hosted a Moroccan delegation visiting France to study how we interact with health-sector professionals and in particular the system of negotiated agreements. A similar initiative is underway in Algeria where CNAMTS has conducted a scoping mission – also likely to lead to an agreement providing for exchanges and training programmes on topics such as drugs, official schedules of procedures, smartcards, national agreements, etc.
Many of the requests that we receive concern practical tools - how to organise a fund, set up an inspection system, put in place an information system, for instance. We tend to receive very concrete requests as opposed to questions about the big challenges facing social welfare such as the taxation/contribution debate. These are matters of strategy that are the prerogative of the state.

What are your expectations of GIP SPSI?

The ability to anticipate developments and identify needs, working in partnership with the French players concerned. As I have just mentioned, we are already working with the GIP. The example of Mauritania illustrates how the two of us coordinate our efforts and complement each other. Mauritania, which is in the process of setting up a national health insurance fund, has asked for advice on this matter and exchanges between our respective institutions to share best practices.
The Mauritanians have several ongoing projects, though the priority is accorded to the creation of an information system. This project is to be put out to international tender – an attractive prospect for French operators as it’s an ambitious scheme which will require a long-term input.
Another requirement of Mauritania is a more comprehensive and global approach to its health insurance system – a typical sort of question to be addressed by a scoping mission conducted within the framework of the GIP.
The capacity to anticipate and identify needs (as made possible by the GIP), is crucial in a context where the demand for health protection and sickness insurance is continually growing.