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FREN

Health, Fabien Roussel

Extra-billing by doctors: End extra-billing by doctors

Direction of change: abolition of a scheme, compared with current law.

The lever. Sums charged by some doctors above the social security tariff: regulation, capping, ban. Direction rule: ↑ freer extra-billing.

« aller vers le remboursement à 100 % par la Sécurité sociale de tous les soins prescrits, sans reste à charge. Cela suppose également de mettre fin aux dépassements d’honoraires »1

Translation by the editorsmove towards 100% reimbursement by social security of all prescribed care, with no out-of-pocket cost. This also means ending extra-billing by doctors

Words of Fabien Roussel, pcf.fr, « Franchises médicales : le gouvernement choisit de faire payer les malades » (déclaration signée de Fabien Roussel), 23 July 2026. Position taken from public statements, not from a written programme.

No programme released. Positions taken from public statements, words of associates or documents of the candidate’s party, each dated and sourced; last recorded on 18 October 2026.

Encoding

Position linked to an option of the cost schedule, with no parameter to set: see the costing.

Costing

Announced by the candidate

not announced

The cited source does not cost this measure.

Published costings

none

No external costing of this position recorded to date.

Our calculation

−€5.7bn

per year for the public accounts, new spending, range −€6.6bn to −€4.3bn.

The calculation

  • Abolition with the amounts covered by national health insurance (Assurance maladie) (cost in 2032): Option costed by the source: a cost of €5.7bn (4.3 to 6.6) per year.

Assumption by the editors. Reading adopted, that of his words: the end of extra fees goes with the « remboursement à 100 % par la Sécurité sociale de tous les soins prescrits, sans reste à charge » [“100% reimbursement by the Sécurité sociale of all prescribed care, with no out-of-pocket cost”], hence with the coverage of the amounts by the national health insurance (Assurance maladie), €4.3bn to €6.6bn a year in 2032 (5.7 at the centre). Other reading: a ban on extra fees without coverage, at zero budgetary cost (option costed for Marine Tondelier, whose text caps extra fees without mentioning out-of-pocket costs). The 100% reimbursement of other care, targeted with no timetable (« aller vers » [“move towards”]), falls under other levers.

Coefficient calculated by the editors from HCAAM, « Les dépassements d’honoraires des médecins : état des lieux », octobre 2025 (pages 4 et 22 du PDF): the position is marked as an assumption by the editors.

Current law, sources and limits of the cost schedule

Current law. Sector 2 with unregulated fees « avec tact et mesure » [“with tact and moderation”]. OPTAM moderation scheme. 56% of specialists practise in sector 2. Extra fees reach €4.3bn for specialists and €4.5bn for all doctors in 2024, rising 5% a year in real terms over 2019-2024 (HCAAM, 2 October 2025).

Horizon. full year 2032, €bn/year

Limits. €4.5bn (all doctors, 2024) and +5% per year in real terms over 2019-2024 (+8% in current euros): HCAAM report of October 2025. Central value for 2032: €4.5bn × 1.03^8 (nominal growth of 3%, assumption). High value: €4.5bn × 1.05^8; it applies the real rate of 5% as a nominal rate, and the nominal trend of 8% would give more (calculation: €8.3bn); the range rests on growth assumptions, not on a published costing for 2032. A ban without compensation costs the budget nothing, but may lead doctors to leave the national agreement (déconventionnement) or reduce the supply of care (cannot be costed). Part of the extra fees is already reimbursed by supplementary insurers, and thus not by public spending.

How to read these amounts. These are static costs and revenues, with no feedback effect, over a full year: nothing on growth, employment or the revenue that economic activity would gain or lose. A higher net cost does not on its own make a worse policy, nor net savings a better one: each programme rests on an economic model (demand-led stimulus, lower compulsory levies, consolidation of the public accounts…) that the cost schedule does not settle. GDP itself measures a volume of activity, not well-being or the usefulness of what is produced. Economic models and feedback effects.

This lever in the method · Costing for Fabien Roussel

  1. pcf.fr, « Franchises médicales : le gouvernement choisit de faire payer les malades » (déclaration signée de Fabien Roussel), 23 July 2026. Words of Fabien Roussel. Position taken from public statements, not from a written programme. Read the source (pcf.fr, « Franchises médicales : le gouvernement choisit de faire payer les malades » (déclaration signée de Fabien Roussel)).

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