Angry Taxis: Medical Transport at the Heart of the Problem, What Will the New Pricing Change?

Reimbursements for patient transport by taxi have accelerated significantly in recent years, reaching €3.1 billion in 2024, a 45% increase since 2019, according to figures from the French Health Insurance Agency. Taxis now account for almost half of all medical transport in France (the remainder being provided by light medical vehicles and ambulances).

In total, the new taxi fare scale, and other measures concerning VSL and ambulances, should make it possible to curb the growth in overall medical transport costs by 300 million euros per year over the next three years (for comparison, these costs increased by 440 million euros between 2023 and 2024).

How is this a key activity for taxis?

The subject is very sensitive for taxis because medical transport has become an essential dimension of their profession, especially in the countryside where the distances to reach hospitals are longer.

85% of taxis provide patient transportation, according to figures from the National Taxi Federation. And when they do, this activity represents an average of 50% of their turnover, according to figures from the French Health Insurance Fund. The proportion can rise to 80% or even more for some of them, according to the same source.

The reform unifies a pricing system that currently varies from department to department. It will be based on a standardized flat rate of 13 euros, to which will be added a mileage rate based on the prefectural taxi rate in effect in each department.

The flat rate for care will be increased by €15 in major cities to account for traffic jams. "Targeted supplements are intended to address" certain specific needs - tolls, transport for people with reduced mobility, local specificities, etc.," the health insurance agency also states. The new pricing is also designed to discourage empty return journeys or excessively long waiting times.

Health insurance also requires hospitals to provide transport platforms so that a driver can easily find return transport or shared transport.

To justify its tightening of the screws, the Health Insurance indicates that on average, patient transport by taxi costs 63 euros, compared to 38 euros by VSL (and 115 euros by ambulance).

According to the Health Insurance, taxis are more profitable than other forms of medical transport, and in recent years, it has observed a shift from journeys made by VSL to journeys made by taxi.

Among the protesters, taxi drivers explained that the new fare structure would cause them to lose substantial portions of their revenue. Yves Rubicondo, a taxi driver from Pithiviers (Loiret) who has three employees and generates 95% of his revenue from health insurance, expects to lose 25 to 30% of his revenue.

For its part, the Health Insurance believes that "the majority of taxi companies and businesses will benefit from this new model, with unchanged activity."

"By making some changes to their practices, particularly by optimizing the time spent with patients on board, all taxi drivers can benefit," said Thomas Fatôme , director of Health Insurance, in a letter to taxi federations on Friday.

The new pricing also provides that health insurance may refuse to contract new taxis when an area is already well covered.