Non-Conciliation
On Friday, the mediator appointed for negotiations between the Luxembourg Association of Doctors and Dentists (AMMD) and the National Health Fund (CNS) declared a non-conciliation. The talks have failed.
The CNS said it was disappointed no agreement was reached, but assured patients nothing would change. When the current agreement runs out in two months, a Grand Ducal regulation will come into force, ensuring no interruption to care or reimbursements.
"In practical terms: consultations will proceed under the same conditions as before, and there is no reason to fear any interruption in healthcare coverage or reimbursements by health insurance solely due to the decision announced by the AMMD", the CNS wrote.
The CNS also drew a line between what it controls and what it does not. Some topics discussed in recent months fall under the agreement, such as administrative management. Others, like the organisation of the outpatient sector or autonomy over doctors' fees, concern the healthcare and social security systems more broadly, and are matters for the government to consider.
The CNS added that its insistence on adhering to the legal framework did not mean unwillingness to negotiate. It remains open to constructive dialogue.
Two days ago, the AMMD had already signalled that mediation was heading nowhere. Today, the mediator made it official. The doctors wanted changes to working conditions and fee autonomy that the CNS says are outside its remit. The CNS wanted to stay within the law. Neither side moved far enough.
Patients will not notice the difference, at least not immediately. The Grand Ducal regulation is a safety net, not a solution. The structural questions, about how outpatient care is organised and how doctors set their prices, remain unanswered and now move to the political arena.