Disinformation. Work stoppages: are more than half "unjustified," as the government claims?

As savings are sought since François Bayrou 's announcements on July 15, one watchword has recurred in government announcements : we must "put an end to the abuses" of "prescribing sick leave by doctors." "We must put an end to this trend," the Prime Minister declared in mid-July, adding that "the checks carried out on sick leave of more than 18 months have shown that for 50% of them, these work stoppages were no longer justified."

"The checks that were carried out on sick leave of more than 18 months showed that, for 50% of them, these leaves were no longer justified," added his Minister of Solidarity 10 days later, in Le Monde . In turn, the Minister of Health Yannick Neuder advanced on July 30 that "50 % of work stoppages of more than 18 months were unjustified during health insurance checks." Catherine Vautrin returned to the subject again at the beginning of August .

Often, in the political discussions that animate the summer, the term "fraudulent" or "abusive" replaces the word "unjustified." With a simple, almost miraculous promise in mind: it would be enough to be more scrupulous about sick leave (nine million files per year) to hope to reduce their cost by half.

Except that this "50%" figure... doesn't exist. Every year, the Health Insurance publishes its annual report, soberly titled "Income and Expenses." Several hundred pages detail all expenses and revenue, supplemented with recommendations and various ideas. The document even includes contributions from trade union organizations.

But this 50% is not there. It is, however, (almost) in an attached presentation document ... and refers to something completely different from abusive sick leave. "Spot medical checks on sick leave of more than 18 months showed that 54% of the sick leave affected by these checks were no longer justified, with the possibility of the employee returning to work or being transferred to disability."

So it's 54%, not 50. But not "54%" of sick leave: only a small number of them, "chosen" - because initially suspect - from the already very reduced scope of sick leave of more than 18 months (the most costly, but the least numerous: sick leave of more than a year represents only 3% of the total, but 25% of the cost).

A journalist from the Medical Press Agency obtained detailed data from the National Health Insurance Fund (CNAM). It is reported that 18,585 work stoppages (out of a total of nine million) lasting more than 18 months were targeted for inspection.

And that's not all: while 54% of them were indeed deemed "unjustified," almost all of them were not "abusive" or "fraudulent." According to the CNAM, only 12% led the medical advisor to recommend a return to work. For the others, "the person was no longer covered by sick leave, but by a disability pension." In short, they should therefore "get out" of the sick leave system... but to be compensated for incapacity. While "fraudulent" sick leave does exist, they are estimated at around 1 to 3% of the total by the Health Insurance. Far from the 50 or 54% sometimes put forward in recent days.

Doctors have had little appetite for the repetition of this "50%" figure - like Jérôme Marty, himself a general practitioner and president of the French Union for Free Medicine union, on X.

He denounces "talking points" from the government, which "send the message that all doctors and all patients are guilty" of the social security deficit.

For the time being, Catherine Vautrin wants to "limit any initial work stoppage to 15 days in general practice" and to "one month after leaving hospital."