Paris – 09.06.2026: The Haut Conseil pour l’avenir de l’Assurance Maladie (HCAAM) has warned in a recent report of a sharply rising number of specialists who charge additional fees. According to projections, up to 90% of specialists could apply such additional charges by the year 2040, leading to a significant increase in the cost of healthcare.
In 2024, the additional fees charged by specialists already amounted to around 4.3 billion euros. This corresponds to an annual increase of about 5 percent since 2019. The main cause is the growing share of doctors practicing in the so-called Sector 2. These specialists are allowed to vary their fees above those set by the statutory health insurance and to charge higher fees. While 37 percent practiced in this sector in 2000, now 56 percent of specialists work in Sector 2. Among newly established specialists, even three quarters are active in this sector – compared to two thirds in 2017.
The financial consequences for patients are significant. The additional fees represent an important part of the income for certain specialists but can also considerably increase patients’ out-of-pocket expenses. A concrete example: for a hip prosthesis operation, patients pay an average of 630 euros in additional costs, with 10 percent of cases exceeding 1,000 euros in extra fees. Overall, these expenses make up about 14 percent of patients’ total copayments after reimbursement by the statutory health insurance.
The HCAAM emphasizes that without suitable countermeasures, this trend could continue and exacerbate inequalities in access to medical care in the long term. This would particularly affect patients with lower incomes harshly.
Therefore, the HCAAM calls on the responsible health authorities to immediately enforce stricter regulations on Sector 2 and effective measures to limit additional fees. Early intervention should prevent the financial burden on insured individuals from further expanding and the healthcare system from suffering under this development.
Already in a 2025 report, the HCAAM warned of an “out of control” fee dynamics. At that time, additional fees had risen to 4.5 billion euros.
The newly published figures and projections increase pressure on politicians and health institutions to find effective solutions. How the government and health insurers respond and which measures will be implemented to cap the additional costs for patients remains to be seen.
Overall, the HCAAM report reveals a serious challenge for the French healthcare system that requires early and consistent regulation in order to ensure affordable and equitable medical care.