The Quadripartite Committee met on Wednesday 6 May, but under the chairmanship of the Minister for Health and Social Security, 
Following an estimated deficit of €102.1m for 2025, the accounts will be in the red in 2026 with a deficit of €126.5m. For this year, expenditure is expected to rise by 6.4% to €5.18bn, whilst revenue is projected to increase by only 6% to €5.062bn, the minister explained. She added that if this “structural” trend of expenditure growing faster than revenue were to continue, the statutory minimum reserve requirement of 10% would no longer be met by 2027. The penalty would be immediate: an automatic increase in contributions and cost-cutting measures.
This is a prospect the minister rejects. There is no question of “removing” certain procedures from the reimbursement scheme or of lowering the overall reimbursement rate. Nor is there any question of increasing contributions. These would be explosive measures in the current social climate. But for how long? In response to this question, Martine Deprez says that this will also depend on how the economy develops. “For the time being, the contribution from insured persons will remain the same.”
Making the system more efficient
To turn things around, the minister is counting on the goodwill of all stakeholders to “ensure a structural transformation of the healthcare system towards greater quality and efficiency”. “A profound structural change,” she says.
“We need to adapt the national model to ensure its long-term viability in the face of future challenges,” a transformation based on three main pillars. The first is the pursuit of greater efficiency. Martine Deprez emphasises the need for better coordination of human and financial resources, particularly with regard to hospital stays and the use of medicines. To achieve this, Luxembourg aims to align itself with international standards, particularly for medical tests and treatments, to ensure that the tools used are the most appropriate and effective.
At the same time, there is a strong focus on precision medicine and strengthening preventive measures, with the aim of providing more personalised care and anticipating the onset of diseases.
No privatisation of the health service
The minister has denied any intention to privatise the healthcare system or introduce a two-tier healthcare system, as the trade unions have accused her of doing. She speaks of “exploring public-private partnerships to improve operational efficiency”. “The aim remains to provide high-quality care whilst maintaining a protective social safety net.”
Another hot topic in the news is the renewal of the agreement between the National Health Fund and doctors. The continuation of the contractual system has been reaffirmed “as the cornerstone of the model”. Discussions are ongoing, says the minister, who believes the ball is now in the doctors’ court. Should the agreement not be renewed, a Grand-Ducal Regulation would need to be adopted. The ministry is preparing for this. “This will make absolutely no difference to patients,” insists the minister. And this regulation would be repealed as soon as an agreement is reached.
A saving of €96m and greater control
Until everything is in place, we’ll have to make savings! The stated aim following the four-party talks is to achieve a reduction in expenditure of €96m. Among the measures under consideration — “useful and necessary measures”—are efforts to tackle the wasteful use of medicines, efficiency measures in hospitals—notably including a reduction in the length of stays—as well as strengthening the means to combat abuse and fraud. The minister mentioned the possibility of “automated verification of pricing rules”.
To be continued.
