The crisis in New Caledonia. 7 points to better understand the health assistance system that benefits nearly 55,000 people

As early as the beginning of January 2023, the Province of the South and the Islands submitted a text to Congress requesting that the budget be transferred to New Caledonia. This text has not yet received a response.

This is a device that involves more than just 55,000 Caledonians Today across the country, Medical Assistance enables the most vulnerable families to access care more easily, free of charge or partially free of charge.

In New Caledonia, this competence was left to the provinces in 2000. Consequence: different conditions and formalities. “New Caledonia has established a minimum general framework, which is implemented by the provinces within the framework of their mandates established by Organic Act No. 99-209 of 19 March 1999, in order to meet the needs of the communities.providing detailed information about government services.

Not surprisingly, the system affects provinces unequally.

South : Figures for 2023 show that the Southern Department has nearly 25,000 beneficiaries and a total budget of 5.4 billion francs (nearly 203,000 inhabitants according to data from the last census in 2019).

North: In 2023, 18,080 people will benefit from the Northern Province, including 12,961 A-card holders. (Full support) 5,111 B cards (partial coverage), equivalent to a budget of 3.6 billion francs, a decrease of 8% (almost 50,000 inhabitants, according to data from the last census in 2019).

Ayers: In 2022, the province of the Islands has 11,417 beneficiaries, of which 7,964 are A-cards and 3,453 are B-cards (according to data from the last census in 2019, the number of inhabitants is slightly more than 18,000).

According to them, this envelope puts pressure on the budgets of the provinces, so South As islands Hope to see her back in New Caledonia.

In January 2023, the topic was even brought to Congress, where members were asked to decide on a Proposed national law It was presented by Sonia Backès, the governor of the South Department, and Jacques Lalié, the governor of the Islands Department.

A transfer proposal that has Caledonians reacting in unison It was explained at the time that New Caledonia was already over-indebted,Digging New Caledonia’s Graves.

The advisory bodies (Cése, the Regional Finance Council and even the Council of State) expressed reservations.

The text was not reviewed. After being withdrawn from the agenda on January 10, 2023.

The support system is targeted at low-income families who have difficulty affording medical care. The assistance is only available in New Caledonia or as part of a medical evacuation outside of Le Caillou.

To benefit from it, you must comply with three main criteria:

• Lived in the province for more than 6 months.
• The centre of their moral and material interests is in the province in question.
• Have resources below the minimum agricultural wage guarantee, or 140,280 CFA francs from 15 February 2023 (the ceiling increases by 20% for each additional dependant in the Southern Province).

Budget cuts have become more urgent due to the massive crisis New Caledonia has been experiencing since May 13. There are some concerns about health assistance in the South Province, and the meeting that ends on Thursday, July 11, is expected to provide answers.

For the vice-chairman of the Medical Association Council, deleting it would be counterproductive. “Honestly, I don’t think any current New Caledonian politician would say it’s over. That would be a testament to courage, but also a lack of empathy. It’s simply unimaginable.”Dr. Paul Bejan believes. ”In mainland France, and even in the United States, there are still minimum guarantees.”

One of the professional’s concerns is that some patients leave the healthcare setting. “They either don’t come or they can’t pay. If they don’t come, they risk getting seriously ill and spending more.”

The prospect of abolishing the system provoked reactions from doctors and Caledonians.

Natacha Lassauce-Cognard and Mirna Kilama report:

Today, Caledonians who benefit from medical assistance are entitled to varying degrees of partial or full coverage of medical expenses, depending on the circumstances. The validity period varies depending on the type of card.

• Card A : For those who have no other social security. It provides care services in the public sector (hospitals, pharmacies, Cafat reception centres and Rivière Salée centres) and in public sectors approved or authorized to receive beneficiaries of medical assistance.
  
• Card B : For those who have other social security (Cafat, approved mutual insurance company, insurance). It allows access to all sectors (public and free).
  
• M Card : It concerns pregnant women who have no support and are not eligible to benefit from another card (A or B).
  
• Card C : It is aimed at veterans, FFL volunteers and war widows. The C-card allows access to care only within the framework of hospitalization in the public sector.
  

Medical Assistance covers care that is:

• Fees for doctors, dentists and medical assistants or any AMN approved health professionals.
• drug.
• The cost of hospitalization, ambulance transportation and even analysis.
• Medical evacuation costs.

Please note that in the Southern Provinces, Medical Assistance holders must pay the 10% procedure through a deductible, while this is not the case in the Northern Provinces and the Islands Provinces.