Les f\u00e9d\u00e9rations repr\u00e9sentant les \u00e9tablissements de sant\u00e9 publics, priv\u00e9s \u00e0 but non lucratif, priv\u00e9s et d\u2019hospitalisation \u00e0 domicile alertent sur les cons\u00e9quences de l\u2019\u00e9volution de l\u2019ONDAM 2027 pour les patients et l\u2019offre de soins. Elles estiment qu\u2019il manque 1,3 milliard d\u2019euros pour permettre aux \u00e9tablissements de faire face \u00e0 la hausse des charges, couvrir les besoins croissants de soins de la population et r\u00e9pondre aux enjeux d\u2019acc\u00e8s aux soins.<\/p>\n
Ces organisations appellent d\u2019abord \u00e0 l\u2019adoption, dans les d\u00e9lais, du Projet de loi de financement de la s\u00e9curit\u00e9 sociale (PLFSS), en soulignant que, compte tenu de la fragilit\u00e9 financi\u00e8re actuelle du secteur, les \u00e9tablissements ne pourraient supporter une ins\u00e9curit\u00e9 juridique et budg\u00e9taire suppl\u00e9mentaire.<\/p>\n
Elles contestent par ailleurs la pr\u00e9sentation de la hausse de 3 % de l\u2019ONDAM \u00ab \u00c9tablissements de sant\u00e9 \u00bb pour 2027. Selon elles, ce taux repose sur un objectif 2026 abaiss\u00e9 de 180 M\u20ac en raison du gel d\u00e9finitif de cr\u00e9dits mis en r\u00e9serve sur les financements par dotations. Rapport\u00e9e \u00e0 l\u2019objectif initialement vot\u00e9, la progression r\u00e9elle ne serait, d\u2019apr\u00e8s elles, que de 2,8 %, incluant la compensation de la hausse des cotisations \u00e0 la Caisse nationale de retraites des agents des collectivit\u00e9s locales (CNRACL).<\/p>\n
Les f\u00e9d\u00e9rations signalent \u00e9galement la diminution de l\u2019objectif 2026 du Fonds d\u2019intervention r\u00e9gional (FIR), \u00e0 hauteur de 150 M\u20ac, du fait du gel d\u00e9finitif de cr\u00e9dits mis en r\u00e9serve. Elles rappellent que le FIR finance des missions essentielles comme la permanence des soins et la prise en charge des patients en situation de pr\u00e9carit\u00e9. Selon elles, ces gels affectent non seulement les financements 2026 mais r\u00e9duisent aussi durablement la base de reconduction de l\u2019ONDAM pour 2027 et les ann\u00e9es suivantes.<\/p>\n
Elles demandent la pr\u00e9servation des dotations finan\u00e7ant des missions qui ne peuvent reposer sur les seuls tarifs de s\u00e9jours (enseignement, recherche, innovation), ainsi que des moyens d\u00e9di\u00e9s aux urgences, \u00e0 la psychiatrie, aux m\u00e9dicaments et dispositifs m\u00e9dicaux co\u00fbteux et aux actes innovants. Elles estiment que le FIR ne doit pas \u00eatre utilis\u00e9 comme variable d\u2019ajustement au d\u00e9triment de la permanence des soins et de l\u2019accueil des publics pr\u00e9caires.<\/p>\n
Concr\u00e8tement, les f\u00e9d\u00e9rations sollicitent la r\u00e9int\u00e9gration dans l\u2019ONDAM 2026 de 180 M\u20ac de cr\u00e9dits mis en r\u00e9serve sur les dotations MIGAC de l\u2019ONDAM \u00ab \u00c9tablissements de sant\u00e9 \u00bb et de 150 M\u20ac de cr\u00e9dits mis en r\u00e9serve sur les dotations du FIR. Elles demandent \u00e9galement la restitution de 440 M\u20ac de coefficient prudentiel pesant sur les tarifs des s\u00e9jours, afin de soutenir l\u2019activit\u00e9 des \u00e9tablissements.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)\u200bLire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" Les f\u00e9d\u00e9rations repr\u00e9sentant les \u00e9tablissements de sant\u00e9 publics, priv\u00e9s \u00e0 but non lucratif, priv\u00e9s et d\u2019hospitalisation \u00e0 domicile alertent sur les cons\u00e9quences de l\u2019\u00e9volution de l\u2019ONDAM 2027 pour les patients 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