Devastation of health care in Greece

By Robert Stevens
28 February 2014

Health care provision to millions of people in Greece has been wrecked by the crippling austerity imposed since 2010. Recent studies reveal a tragedy in which the population has faced a terrible social reversal only previously known in wartime.

The latest barbaric act of the government, at the behest of the European Union-led “troika”, was the closure of the entire state-run outpatient clinic network for one month in order to introduce the new Primary Healthcare Network (PEDY). As a result, 8,500 medical and administrative clinic staff have been suspended on reduced pay during the closure. These workers will likely be sacked, like many thousands of other state employees under the “labour mobility scheme.”

Among the changes to legislation is a measure that would allow public hospitals to fire physicians who also have private practices. In protest, thousands of doctors gathered outside the Health Ministry in Athens earlier this month. Following the demonstration, the doctors marched to the Greek parliament as the bill was being debated.

Doctors and other health workers occupied a number of clinics run by the main state provider, EOPYY, refusing to hand over control and equipment. Clinics in Ambelokipi and other parts of Athens and on several Aegean islands were among those occupied.

A recent paper by the renowned British medical publication the Lancet noted that 2013 “was the sixth consecutive year of economic contraction” in Greece, with the “economy shrinking by 20 percent between 2008 and 2012, and anaemic or no growth projected for 2014.”

The report examined “the mounting evidence of a Greek public health tragedy.”

It explains, “Greece has been an outlier in the scale of cutbacks to the health sector across Europe. In health, the key objective of the reforms was to reduce, rapidly and drastically, public expenditure by capping it at 6 percent of GDP. To meet this threshold, stipulated in Greece’s bailout agreement, public spending for health is now less than any of the other pre-2004 European Union members.”

In a country with a population of just over 11 million people, more than 800,000 have no access to unemployment benefits, which entitles them to free health care.

Through a series of austerity measures, “the public hospital budget was reduced by 26 percent between 2009 and 2011.”

The paper notes that the troika demanded that publicly funded pharmaceutical expenditure be slashed, with a target of reducing spending from €4.37 billion in 2010 to €2.88 billion in 2012 being met and a further target put in place to cut this to €2 billion by 2014—less than half the previous total.

One result is that malaria, a disease eradicated more than 40 years ago in Greece, has returned, due to cuts in mosquito-spraying programmes and a general decline in health provision.

HIV incidence has risen among injecting drug users more than 10-fold from 2009 to 2012. Tuberculosis incidence among injecting drug users doubled in 2013. State funding for mental health decreased by 55 percent between 2011 and 2012. Levels of major depression increased 2.5-fold between 2008 and 2011. Suicides increased by 45 percent between 2007 and 2011. Infant mortality jumped by 43 percent between 2008 and 2010. The percentage of children at risk of poverty increased to 30 percent in 2011, with a growing number receiving inadequate nutrition.

The “long-term fall in infant mortality has reversed, rising by 43 percent between 2008 and 2010, with increases in both neonatal and post-neonatal deaths,” the report states. The Lancet cited a National School of Public Health report that revealed a 21 percent rise in stillbirths between 2008 and 2011, attributable to reduced access to prenatal health services for pregnant women.

The cost of health care has been deliberately shifted onto patients, “leading to reductions in health-care access.”

“In 2011, user fees were increased from €3 to €5 for outpatient visits (with some exemptions for vulnerable groups), and co-payments for certain medicines have increased by 10 percent or more depending on the disease. New fees for prescriptions (€1 per prescription) came into effect in 2014.”

In Greece, patients must pay 25 percent of the cost of the medicine needed, while the rest is paid by the health care system. But if the medicine is not on the national health care list, the patient must also pay 50 percent of the price difference.

This week, the Doctors of the World group presented findings that more than 2,000 Greeks a day are losing access to free or subsidised health care. The organisation’s president, Alvaro Gonzalez, said, “About 873,000 people do not have access to the national health system and about 2,300 more lose access each day.”

Reports of the human toll of Greece’s health tragedy proliferate. As of February 27, the number of Greeks who have died from flu this year reached 64. Nearly 200 people have been admitted to intensive care units for flu in the last two months. The Medical Association of Athens stated that 40 percent of the high-risk population have not been inoculated for seasonal flu and claimed that pharmacists had not been supplied with sufficient quantities of flu shots.

Last week, the Washington Post reported that the number of those uninsured for health care has soared from fewer than 500,000 in 2008 to at least 2.3 million, or almost one in five Greeks.

Among the harrowing stories it described was of a hospital that would not release a newborn baby to its uninsured mother unless a payment was made. A volunteer-run free clinic, operating out of the former barracks of an abandoned US military base in south Athens, had to step in to resolve the situation.

This month a delegation of eight German doctors examining the health care crisis in Greece gave their blunt verdict. They likened Greece the state of health care as “shocking” and only comparable to that of a “war zone,” stating, “If such brutal austerity measures had been implemented anywhere else, society would have collapsed.”

Their assessment is apt. The troika acts like an invading army of occupation. The Lancet report notes that “former Minister of Health, Andreas Loverdos, admitted that ‘the Greek public administration…uses butcher’s knives’ [to achieve the cuts]” demanded by the troika.

From day one, when the social democratic PASOK government began imposing billions in spending cuts, their devastating consequences were fully known to these hired “butchers.” On a TV show at the beginning of February, Health Minister Adonis Georgiadis, of the far-right LAOS party, admitted he lied about the known impact of the austerity programme agreed on with the troika. Georgiadis said, “The first days of the memorandum, I was publicly showing much more optimism than I truly felt. For example, I was saying to the Greek people, that the memorandum is nothing that we should worry about, while we all knew that it was our doom. It was difficult to tell to the Greek citizens that ‘you are doomed’.”

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