Complementary universal health coverage, the legitimacy in question

This article analyzes why some physicians and dentists refuse consulting patients covered by public meanstested complementary health insurance (CMUC). The data came from a situation testing study (phone calls), analyzed with statistical and qualitative approaches, and 20 qualitative in-depth face-to-face interviews with physicians and dentists. Among sector 1 GPs, the health care refusal rate was very low. In sector 2, where physicians are allowed to charge over the statutory fee, 16% of GPs refused to provide care to CMUC patients.When considering both sectors together, the refusal rate was about 40% for dentists or specialists. The main reason for refusal appeared to be related to the fact that sector 2 physicians cannot charge CMUC patients for more than the statutory fee, so they get a lesser revenuewith those patients. Our results also showed that physicians reject the principle of free access to complementary insurance. In addition, the threshold effect contributed to perceive the CMUC as unfair.