Luxembourg doctors' union backtracks on key demands after criticism

The Association of Doctors and Dentists (AMMD) has clarified its position on reforming Luxembourg's healthcare system, walking back some of its earlier demands following public debate.

During a press conference on Thursday, the AMMD stated that claims it desires a class-based healthcare system are inaccurate. The press event served to clarify its stance and detail its specific objectives.

This clarification comes after the AMMD terminated its agreement with the National Health Fund (CNS) in late October, a move intended to force new negotiations concerning the entire healthcare sector. Its initial demand for greater "rate autonomy" had drawn criticism.

On Thursday, the AMMD sought to distance itself from the narrative put forward by Health Minister Martine Deprez, which suggested the association wanted individual doctors to charge different prices for the same procedure. AMMD President Dr Chris Roller stated this was never the goal, conceding that the term "rate autonomy" was "perhaps poorly chosen."

Instead, Dr Roller and AMMD Vice-President Dr Carlo Ahlborn specified their core demand: the ability to perform new treatments. For this to happen, the CNS must first officially recognise these treatments and then negotiate a reimbursement rate. The AMMD accuses the CNS of deliberately prolonging these negotiations.

To streamline the process, the AMMD proposes that respective medical committees draft proposals for new treatments and rates, which would then need approval from the Medical Board. The CNS would subsequently decide what it is willing to pay.

A key concern for the AMMD is that the current system does not account for rising real costs. Dr Ahlborn drew a comparison to bakers or carpenters, who can adjust their prices to reflect increased expenses, whereas doctors are bound to fixed rates.

AMMD backtracks on private investors

In a significant shift, the AMMD also announced it has decided against its previous call to allow private investment in medical practices. Dr Ahlborn reiterated, however, that this concession is contingent on the CNS taking the real costs of running a practice into consideration.

The association further highlighted the competitive disparity its members feel, stating that self-employed doctors are strongly disadvantaged compared to hospitals. The AMMD also accused the Federation of Luxembourg Hospitals (FHL) and trade unions of deliberately attempting to divide the medical profession – an accusation Dr Roller had first levelled in an RTL Radio interview earlier in the week.

Dr Roller repeated another point of criticism: that the CNS agreement automatically applies to new doctors, leaving them no room for negotiation.

Finally, the AMMD representatives reiterated a separate structural demand for the insured to be directly represented on the CNS board. They argue that trade unions do not represent all insured individuals, as not every patient is an employee.

Full report by RTL Télé (in Luxembourgish)

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