Luxembourg's new National Health Fund (CNS) president, José Balanzategui, has stepped into the role with immediate challenges ahead, as the Association of Doctors and Dentists (AMMD) followed through on its threat to terminate its agreements with the CNS.

For insured patients, the move has no immediate consequences, since the current convention will remain valid for 12 months. During that time, however, long-standing disputes within the health system, both practical and ideological, will have to be resolved, Balanzategui explained.

He clarified that the termination simply means the two sides will now have to set a date for new negotiations: the official announcement will appear in Legilux, after which discussions on the next framework agreement will begin.

The conventions define the administrative and financial framework between doctors and the CNS. The AMMD argues that this system has become too rigid, outdated, and burdensome, and insists it should be more flexible, giving doctors greater autonomy over tariffs and allowing broader reform of the healthcare model.

Balanzategui responded that such structural demands go beyond what can be negotiated directly within the framework of the conventions, since they are matters defined by the Social Security Code. He added that questions about tariff freedom or fundamental reform are political issues that must first be addressed by the government, which would need to amend the relevant legislation before such changes could be implemented.

Minister of Health and Social Security Martine Deprez has meanwhile indicated that the government is already working on measures outlined in the coalition agreement, including the development of out-of-hospital medical activities and new doctors' group practices.

Balanzategui noted that such reforms would raise further questions about how these activities should be financed. If medical services are performed outside hospital settings, the CNS would eventually need to introduce specific tariffs covering equipment, staff, and operating costs. He explained that, at present, the law does not yet provide for this.

Whether these changes would actually reduce healthcare costs remains uncertain. Expanding outpatient services could, in theory, improve efficiency, but transferring activities from hospitals might also increase their own costs, potentially fuelling fears of a two-tier health system.

Despite the tense context, Balanzategui said he was well aware of the challenges when he accepted the role. After more than 25 years within the CNS, he said he knows the pressures that come with the job, having observed them first-hand under his predecessors. Still, he expressed confidence in his experienced and highly motivated team, emphasising that he is ready to tackle the negotiations ahead.