Insurance

Represent users in the Caisse Primaire d’Assurance Maladie (CPAM)

Interview of Philippe QUIQUE, RU at the CPAM of Yvelines

After 4 years of mandate, the renewal of the User Representatives (RU) in Councils of the Primary Health Insurance Fund (CPAM) is in progress. What is the role of the UK within this body? How can the voice of users be heard there? Philippe QUIQUE, Representative of Users mandated by France Assos Santé at the CPAM of Yvelines (78) testifies.

CPAM, what is it?

The Caisse Primaire d’Assurance Maladie (CPAM) is a private law organization with a public service mission. It ensures close relations with the public health insurance. It is made up of a Council and commissions resulting from this Council.

The first college of the Council is made up of the representatives of the insured persons designated by the trade unions and the second college of the representatives of the employers. The third college brings together representatives of Mutual Insurance, User Representatives (France Assos Santé, FNATH and UNAF), a representative of UNAPL and a qualified person.

In each department, there are 4 User Representative positions for France Assos Santé: 2 incumbents and 2 alternates

Within the CPAM of Yvelines, I sit on two committees: the financial penalties committee and the local joint committee of the Professional Territorial Health Communities (CPTS). The first pronounces penalties against beneficiaries, employers or healthcare professionals who commit fraud and the second monitors and organizes the CPTS at departmental level.

What is the UK’s role in CPAM?

Through its presence on the CPAM committees, the UK communicates and promotes the needs of users to the fund’s services in order to improve their health care journey. Thanks to the information collected from user associations, it makes known the difficulties encountered in terms of access to care and expresses their various expectations.

For example, the implementation of telephone or digital contact platforms within CPAMs has shown that some people encountered difficulties in contacting the services of the fund, thus causing the loss of contact with users. As UK, we were able to overcome these difficulties which are very real. The RUs can bring a fresh perspective and expertise thanks to their knowledge of the field.

This role of transmission is also valid in the opposite direction: as an RU, I am the recipient of information directly linked to health news in my department that I communicate to my local association.

What qualities are expected to sit on the CPAM?

Of course, the training courses followed during our mandate as RU are important, but they are not everything. Proximity to users gives us legitimacy to defend them and carry their voice. It is also necessary to show curiosity and not hesitate to take an interest in each commission to get an idea of ​​the subjects dealt with there. It is also necessary to listen to the expectations of users and not hesitate to express oneself when necessary.

What advice would you give to RUs wishing to engage in this forum?

During this mandate, exchanges between incumbent and substitute, but also between user representatives of other patient associations, are to be favoured. These make it possible to better understand the functioning of the body and to better prepare the meetings in order to facilitate the taking of positions. Organizing more meetings or exchange days between RUs of different families would allow this work to be done together. France Assos Santé Ile-de-France will offer this type of meeting in 2022.

Moreover, when the UK does not feel comfortable with the subjects dealt with in a committee, I would advise not to hesitate to exchange places with its holder or his deputy who may be more interested or to change commission if possible.

Some messages will sometimes be difficult to convey to all participants, but our presence within this body is essential to make the voice of users heard. Health Insurance is one of the pillars of the French health system. Representation of users is therefore essential within this institution.

Useful information

UK CPAM mandates last 4 years. You must be under the age of 66 at the time of appointment, not be a practicing health professional, or a member of a social security organization. Coverage of transport costs is provided for getting to the committees as well as compensation of €30 per session.

Does this mandate interest you?

Contact us: Julie Giraud – jgiraud@france-assos-sante.org – 07 56 34 11 23

For more information see:

About the author

on100dayloans

Leave a Comment