Luxembourg's major unions are calling for immediate reforms in the National Health Fund (CNS) to enhance service quality and manage escalating costs, as they prepare for a pivotal quadripartite meeting with government officials in Dudelange on 6 November.

Luxembourg's major unions have announced that they will jointly call for improved services and cost management within the National Health Fund (CNS) at the first quadripartite meeting of the new legislative term. The meeting is set to take place at the Op der Schmelz cultural centre in Dudelange on 6 November.

Representatives of the CGFP, FGFC, LCGB, and OGBL, who are on the CNS administrative board, have thus added a number of points to the agenda of the upcoming session, including a demand for updates on promised service enhancements and a review of CNS financial obligations.

Improving reimbursements

Unions argue that longstanding commitments made in the 2016 quadripartite accord to improve reimbursements for dental treatments and vision aids have largely gone unfulfilled. While minor adjustments, such as covering certain periodontal treatments and special lenses, have been made, significant promises remain unmet.

These improvements are still "empty promises", the unions claim, citing unfulfilled commitments like coverage for composite fillings, implants, and better reimbursements for glasses and contact lenses.

CNS budget deficit

Additionally, unions allege that the CNS' financial reserves have increasingly been used to cover costs outside its scope, straining the fund. This issue, they argue, has worsened the CNS budget deficit, leading to a "negative trend in the CNS reserve". In a prior quadripartite meeting, held in May 2022, a working group was set up to address these concerns, but unions say significant action is still needed.

A specific point of contention is the maternal allowance, which has remained capped at €20 million since 2011, despite actual costs now nearing €40 million. The unions estimate that the cumulative shortfall from 2011–2024 has amounted to around €150 million. They therefore contend that "all administrative costs of the CNS should be borne by the state budget", as well as CNS' mandated 20% contribution toward hospital infrastructure, which they say should fall under the state's jurisdiction.

Cost adjustments

Union representatives argue that these changes could enable CNS to focus solely on its "core business", such as covering medical reimbursements and providing sick pay. Furthermore, they claim that appropriate state support could facilitate essential improvements to dental and vision reimbursements, where insured individuals currently bear 50% and 75% of the costs, respectively.

Calling on Luxembourg’s Health and Social Security Minister, the unions state that the swift implementation of cost adjustments, alongside other measures, could stabilise CNS finances and ensure sustainability beyond 2027. The unions expect the Minister to present "concrete proposals for swift implementation in the interest of all insured people".