Who will pay for Luxembourg's health deficit?

Luxembourg's healthcare system is facing a worrying crisis: the national health insurance fund (CNS) is deepening into a deficit that could reach €132.6 million as early as 2025. The Quadripartite Committee estimates that this will amount to 16.5 per cent of annual expenditure - a level that threatens the stability of the entire system. The CNS reserves, if no action is taken, could fall below the legal minimum as early as 2027.

Against this backdrop, the Luxembourg Association of Doctors and Dentists, AMMD, issued a strong statement accusing the authorities of trying to shift responsibility onto doctors and patients. The doctors insist that neither they nor their patients are to blame for the shortage and should not have to compensate for it.

In its press release, AMMD points to structural problems in the CNS itself, including rising administrative costs and a lack of unity in the management of the fund, where 40 per cent of votes belong to the state and 30 per cent each to representatives of employers and employees. The association emphasises that the interests of these parties are often diametrically opposed, which means that it is difficult to expect systemic solutions.

The doctors also expressed dissatisfaction with the lack of progress on long-promised reforms, including a bill drafted with the Medical Board that could legalise new forms of medical practice, particularly outpatient diagnostics and minor surgery. Such an approach, according to AMMD, would have reduced the burden on hospitals and helped contain costs. But the project was withdrawn without explanation at the beginning of the current legislative period - and has not yet been revived.

The 2018 Hospital Act was also particularly criticised, which the AMMD described as "bad" and its latest 2023 edit as "unworkable and passed at the last minute".

Doctors warn: if constructive dialogue with CNS is impossible, the problem becomes purely political. And if the government goes down the path of simply increasing costs for citizens, it will be nothing more than an attempt to plug holes at the expense of the population, masking the shortsightedness of past decisions.

Health Minister Martine Deprez confirmed after the committee meeting that the situation requires "urgent action". A list of measures to restore financial sustainability is promised to be presented in autumn 2025.

At this time, doctors expect not just numbers, but a reboot of healthcare with a focus on outpatient care, reasonable financing and real reforms rather than spontaneous decisions at the expense of quality and accessibility of medical services.