Social security: €9 billion to find, and workers and patients are the ones footing the bill

According to Le Figaro, which publishes a "décryptage" (analysis) today, 2 November, Sébastien Lecornu plans to bring the Sécurité sociale deficit down from €21.8 billion to €12.7 billion by 2027, which means more than €9 billion in savings. The paper calls the approach "ambitieuse" (ambitious) and notes that it implies "choix impopulaires" (unpopular choices). The details of the measures do not appear in the material available to us: we do not yet know which spending will be trimmed, or which revenues will be tapped.

What follows is our reading, not an established fact.

Vocabulary first. "Un déficit à réduire" (a deficit to be reduced), "des choix impopulaires": the phrasing sounds like a law of nature, like rain in November. Yet a deficit is not a weather event. It is the difference between contributions collected and benefits paid, and every term in that subtraction results from political decisions: which earnings are subject to contributions, which exemptions are granted, which treatments are reimbursed. To speak of the deficit as something that "demands" effort is commodity fetishism applied to public accounts: the numbers act, the decision-makers vanish.

The useful question, then, is where the €9 billion comes from. There are, broadly speaking, two taps. Either you squeeze spending, meaning reimbursements, benefits and hospital resources, and the cost falls on patients and pensioners. Or you widen revenues, and the bill is spread across wages, rents and profits. The "unpopular choices" Le Figaro refers to point, until proven otherwise, to the first tap. The recent history of austerity plans rarely gives priority to the second.

Let us recall what the Sécurité sociale is: a socialised wage. A share of what workers produce, instead of arriving in their net pay slip, is pooled to pay for healthcare, pensions and benefits. Cutting that share lowers total pay, but it is never called a pay cut. The trick is elegant: the levy is taken at the pharmacy counter rather than at the bottom of the payslip.

We can also see here the ordinary role of the state, manager of the common affairs of the bourgeoisie, to borrow the old formula. It is not a neutral referee: it must ensure that capital continues to accumulate, and budgetary discipline is one of its instruments, even if the state retains some room for manoeuvre and remains a site of struggle. Fewer social expenditures also mean, over time, fewer levies on profits, and a workforce more eager to work for almost any price.

So the detailed plan should be read with a pencil in hand: who pays more, who is exempted, who gives up on treatment. Nine billion is a figure. The people behind it have names and prescriptions.