83 Dental care A MAJOR EXPENSE FOR THE FRENCH Dental care A significant Care expenses "excess to be paid" networks represent a considerable allow French people to access expensive care cost in France (prostheses, implants in paricular), thanks to a cap on practitioners' fees Excess to be paid 22.2% Healhinsurance 33.2% €11.3 billion in 2017 3.7 % up to Other cover,of which(CMU) 30% cheaper 40.9% complementary healh insurance coverage Source: IGAS survey of platorms (2017) A COMPREHENSIVE PLAN TO to practitioners. Dental surgeons whose question the compatibility of the contracts OBSTRUCT THE DEVELOPMENT patients received a letter from Santéclair concluded with the care networks with the OF HEALTHCARE NETWORKS mentioning three names of dental surgeons code of ethics. The Isère CDOCD then forwar- belonging to the network were encouraged ded these two letters to all the other depart- The anticompetitive practices adopted by to file a complaint against them with the mental councils so that they could copy its the National Council of the Order of Dentalcompetent departmental council of the practice. Surgeons (CNOCD), and its 5 departmen- college for collusion, poaching or attemp- • The FSDL, for its part, mainly communi- tal councils, and the FSDL, either jointly orted poaching of patients and prohibited cated with its members or supporters to separately, stem from on overarching plan advertising, even though these practitio- try to get them to file complaints against with a single anticompetitive objective, i.e.,ners had not infringed these ethics rules.practitioners that were affiliated to San- to hamper the activity of Santéclair and care téclair, to terminate or refuse to sign any networks in general. Additional, individual actions affiliation agreement with Santéclair, to call Each of these three bodies proceeded to into question the compatibility of the agree- The organisation of a campaign take individual action designed to ensure ments concluded with Santéclair with the of complaints and calls for a the success of this campaign and, more code of ethics. The actions of the FSDL also boycott generally speaking, to hamper the activity targeted the Kalivia and Itélis networks, as In particular, the CNOCD, the CDOCD of Isèreof all care networks, while the Bouches-du-well as the network of Assurances du Crédit and the FSDL jointly organised a campaign Rhône, Dordogne, Haut-Rhin and Bas-Rhin Mutuel (which was in the process of being to encourage dental surgeons to file com- CDOCDs also adopted practices targeting set up and planned to expand into the field plaints with the departmental councils these networks. of implantology), and its future partners, against their colleagues who were affi- • Drawing on its moral authority and abi- such as GACD. liated to Santéclair More specifically, eachlity to influence the departmental councils,• Lastly, the Bouches-du-Rhône, Dordogne, complaint was then to be used to put pres-the CNOCD sent a circular to the latter in Bas-Rhin and Haut-Rhin CDOCDs advised sure on the relevant practitioner during which it was suggested that these networks their members not to enter into or continue the pre-litigation procedure with the aim were breaching the code of ethics The CNOCDtheir contractual relations with networks of getting the practitioner to terminate hiswas therefore encouraging the CDOCDs to as they ran the risk of breaching the code contract with a network. ask practitioners under their jurisdiction toof ethics. Some communications even Dental surgeons were also invited to boy- terminate their affiliation. stated that such breaches could be sub- cott Santéclair nationwide. A letter entitled• As regards the Isère CDOCD, it drafted ject to penalties. “CALL FOR RESISTANCE AGAINST SANTE- and circulated two letters to all practi- CLAIR” was sent out by the president of tioners in the Isère département in early … the FSDL on 8 October 2013 to the other 2014 and early 2015, recalling their obli- members of the board of directors of this gation to register their contracts with the trades union, and then disseminated widelycouncil. These letters tended to call into ACTIVATING TRANSFORMATION