The Greek national debt is never very far from the headlines, with reports of officials fiddling budget figures, youths rioting in the streets and what seems like a endless increase in the number of unemployed. While all this all seems like a shocking and unacceptable situation for a member of the European Union, a recently published open letter addressed to the Greek Government and written by Greek scholars and physicians, has drawn even more negative attention to the situation and highlighted the number of Greek people suffering due to the increasingly strict measures applied to the Greek Health Care service.
The letter indicates that the pressure to meet impossible financial targets set by the troika is creating a "dire" and life threatening situation since public health expenditures reduced from 9.8% GDP (pre-crisis) to 6% GDP.
The healthcare service in Greece has traditionally been covered by national insurance, meaning that medical advice and treatment is free at the point of delivery. However, as the letter addresses, in recent years the quality of this healthcare service has been declining as the Government struggles to provide adequate care.
The squeeze on the healthcare system started several years ago when the number of staff providing care was cut back. The original aim was to economise by reducing the number of employees in bigger hospitals and medical centres, but in fact, that was just the beginning of a whole series of hospital cuts including stalling medical workers' salaries, followed by moves to cut the number of hospitals nationwide.
On the 1st of July 2011, the Ministry for Health and Social Solidarity announced plans to cut hospital numbers from 138 hospitals to just 77 as part of a necessary reform to reduce expenses. Earlier this year, Hundreds of doctors and medical staff protested in Athens about the "dangerous" nature of these cutbacks which have resulted in undervalued and unmotivated healthcare workers.More recently, increased delays in the Ministry of Health's funding to a number of hospitals has lead to medical staff having to resort to old, worn down equipment as well as creating long waits for essential system updates and replacements. In the letter, the reduction in the health care budget is also blamed for an overall lack of resources in hospitals including stocks of very basic medical materials such as surgical gloves, syringes and bandages, to the extent that patients now have to cover the cost of such consumables themselves.
Last year, healthcare budget issues were so severe that it was even a struggle to provide food supplies to hospitals. Yiannis Antartis, the governor of Greek psychiatric hospital, Dromokaitio was so desperate about the situation in his own hospital that he wrote to the health ministry and major political parties warning that patients at his hospital were suffering from being poorly fed, and that it was no longer possible to supply hospital meals at the hospital. Fortunately, members of the community and charities stepped into provide rice, milk and oil, and then as a result of his letter, Antartis was promised a €150,000 payment from Greece's caretaker health minister. However, this amount was considered to be modest when measured against the size of the hospital's debts.
In addition to these macro problems with the government's healthcare budget, the recent letter states that members of the Greek population also have to find the financial means to cover their own personal medical expenses (despite the fact that the average income has been reduced by 40% in recent years). New regulations as of July 2011 state that unemployed Greeks can only claim health benefits for a maximum of one year, and then they must cover the cost of their own treatment.
Considering statistics indicate that, in general, unemployed adults have poorer mental (and physical) health than employed adults, removing health coverage from thousands of unemployed people is estimated to be a very dangerous measure. Reports already indicate that there has been a more than 60% rise in suicides in Greece and surveys support this figure by indicating that the number of cases of depression in Greece has doubled in recent years, with charity helplines also reporting a huge increases in calls.
Cutting public health expenditure has also meant that Greek citizens are forced to contribute more towards the cost of their own medications and operations. According to the letter, Greek patients suffering from chronic diseases must now pay a 25% deductible for the cost of their medication (an increase in 20% since the crisis). There is also currently a "standard rate" for surgery which means that patients have to pay for up 20% of the cost of their treatment themselves in advance of the operation.
For example, this new approach means that a hip replacement surgery at a public hospital costs approximately €1000. This cost is known to be impossibly high for those who need it most- the elderly, who on average receive a basic pension of less than €600. The letter warns that such measures are likely to lead vulnerable members of the Greek population to an early grave. Statistics already show some terrifying results: cuts in HIV-prevention budgets have also seen a 200% increase in the virus, and despite WHO recommendations for 200 clean needles per year for every intravenous drug user; charities supporting drug users estimate that approximately three are available to drug users in Athens.
The letter is full of equally shocking numbers, but the Greek scholars and physicians who co-wrote it do beleive that the situation can still be reversed. Since the problems are caused in the most part by pressures to meet targets set by the economists and financial managers who make up the troika, saying 'no' to them, is regarded the only way to avoid a public-health disaster. The letter stresses the need to re-empower the doctors and healthcare professionals, not just because they are in a position to offer sound advice about healthcare policies and practices, but because if they are not consulted or motivated, the remaining medical workers will leave Greece to find work elsewhere, just like the 4,000 plus highly trained Greek doctors who have already done so.