On RTL Radio on Friday, callers shared their concerns and proposals on Luxembourg's health and social care system with Health Minister Martine Deprez.
As the National Health Fund (CNS) deficit increases, there remains a risk that contributions may have to increase from 2027 if spending cannot be brought under control.
One listener said that if Luxembourg wants to maintain a strong healthcare system, people may have to accept paying more. The caller also argued that sick leave certificates should be checked more strictly.
Deprez said she had plans to discuss the mechanism with the social partners, with more details to follow over the next few weeks. Checks for shorter sick leave certificates are to be strengthened, but one obstacle is the shortage of available doctors. There are 13 or 14 vacancies at the Social Security Medical Control office currently, with a dearth of candidates, Deprez revealed.
A number of doctors have already been questioned regarding the high number of sick leave certificates issued, Deprez continued, and regular interventions will continue to take place. The CNS is also working on a system to summarise doctors' profiles and identify those with excessive sick leave certificates, so that they can be contacted directly, she said.
One caller asked whether doctors were prescribing too many treatments at Mondorf-les-Bains. Deprez said it was hard to say, as individual doctors decide these prescriptions, but that it was something to keep in mind when reviewing the system.
On the topic of contributions, one caller said higher earners should pay more, but that authorities should also consider lowering the ceiling for payments. Deprez responded that this had been discussed in relation to the pension debate and that she was not ready to rule the idea out.
However, she said that, ultimately, it would depend on the social partners as a decision must be taken in collaboration with them. Currently, contributions are capped at five times the minimum wage.
The minister said every measure would be taken to ensure the system was as efficient as possible. This applies equally to prescribing medication, contracts for laboratories, or for taxi-ambulance services.
At the last quadripartite meeting, the partners agreed on a €95 million package to help cover the CNS shortfall. However, this is not enough to cover the full deficit, which exceeded €100 million last year and is expected to rise to €126.5 million in 2026.
Deprez also waved away suggestions of penalising people with unhealthy lifestyles, such as smoking, obesity, and alcohol consumption through higher contributions, as they cost the system more money. She called this "a very dangerous exercise".
Instead, the government wants to focus on prevention and positive incentives, according to Deprez. For example, doctors can prescribe physical activity to help with weight loss, which could also help reduce costs, she concluded.
