During a Tuesday morning interview on RTL Radio, Dr Chris Roller, President of the Association of Doctors and Dentists (AMMD), analysed the financial challenges facing Luxembourg’s National Health Fund (CNS).
Dr Roller asserted that Luxembourg has the potential to deliver optimal healthcare without prolonged waiting times but noted that necessary decisions are being delayed. He criticised the CNS’s governance structure, suggesting its multiple stakeholders do not always prioritise patient interests.
The medical leader placed partial responsibility for the financial situation on the CNS itself. While healthcare providers face increasing cost scrutiny, Dr Roller highlighted the fund’s “enormous” administrative expenses, calling for “substantial structural reforms”.
He cited striking figures from the 2023 General Inspectorate of Social Security (IGSS) report: the CNS spent €124 million on administration – nearly equalling the €150 million reimbursed for all dental services.
The AMMD has proposed several cost-saving measures, including a more targeted approach to medical testing to avoid unnecessary or duplicate procedures.
These concerns emerge as the CNS projects a €133 million deficit for 2025. Current projections suggest the fund’s reserves may fall below the mandatory 10% threshold by 2027, potentially forcing difficult choices between contribution increases or benefit reductions.
A stalled legislative proposal could have transformed Luxembourg’s healthcare efficiency, according to Dr Roller. The draft bill, introduced under the previous government and withdrawn by current Health Minister Martine Deprez in 2024, would have permitted physicians to establish companies – a model offering greater flexibility than traditional joint practices.
Dr Roller explained this corporate structure would enable doctors to perform outpatient procedures like cataract surgeries and colonoscopies in specialised centres rather than hospitals. This would both reduce waiting lists and relieve pressure on hospitals, he noted, estimating 80% of treatments could be delivered through ambulatory care. The AMMD president expressed frustration that the ministry withdrew the proposal without explanation.
Currently, only hospitals may operate external medical centres. Critics of the shelved proposal warned private initiatives might commercialise medicine and drain hospital staff. Dr Roller countered these concerns as unfounded: “The notion that no one would want to work in hospitals anymore is nonsense.” He emphasised Luxembourg’s physician shortage requires innovative solutions, arguing private centres could secure basic care while complementing hospital services.
The AMMD hopes for more constructive dialogue with the CNS moving forward. With Luxembourg’s resources, Dr Roller concluded, “it’s unacceptable that patients are forced to wait themselves sick”.
