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CWIC Posters
Jefferson College of Population Health
11-30-2016
The public health crisis in Greece and its ties to a
failing economy
Anna M. Carleen
Thomas Jefferson University, [email protected]
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Carleen, Anna M., "The public health crisis in Greece and its ties to a failing economy" (2016). CWIC Posters. 28.
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The public health crisis in Greece and its ties to a failing economy
Anna M. Carleen
Sidney Kimmel Medical College of Thomas Jefferson University, Population Health College within a College 2016
Healthcare in Greece
Economic Crisis
Austerity measures affecting healthcare system
Between February 2010 and May 2016, thirteen austerity packages have been passed by the Greek
government. Several of those which have particularly targeted the healthcare system are listed here:
In 2009 the Greek government admitted that the numbers it had been reporting to the European
Union about its national budget deficit were artificially small. The deficit was actually huge, way larger
than what the EU requires of member countries if they want to reap the benefits of being in this
financial network. A benefit of being in the EU is that it makes it much easier for governments to take
out large loans, because lenders trust that a member country will make good on its debts due to the
security it has from being part of the union. This admission by the Greek government came at the tail
end of, and was very much linked to, the global financial crisis felt here in the United States in 2008.
As a result, lenders started enacting stricter borrowing rules, and Greece had to take out even more
loans. By spring of 2010 it was veering towards bankruptcy, and in May of 2010 the first
of three bailout agreements with the troika (International Monetary Fund, European
Central Bank, and the European Commission) was reached. This bailout came with
conditions, or austerity terms, that the Greek government had to agree to. These included deep budget
cuts, steep tax increases, and promises to implement anti-corruption strategies and cut down on tax
evasion.
 Cutting public health insurance for individuals who have been unemployed for over a year
 Reduction in hospital budgets (despite increased public hospital admissions) up to 50%
 Salary freezes and salary cuts for both public and private employees
 Hiring freezes followed by layoffs in the public sector
 Increased health contributions paid by pensioners
 Cuts to the Ministry of Health
 Implementation of drug rationing programs



The second bailout came in 2012 after the recession continued to worsen. The third bailout came in
summer of 2015 after a series of failed negotiations between Greece’s newly in power Syriza party and
the troika, Greece defaulting on its loans, and a popular vote by the Greek people to reject the latest
proposed bailout conditions.


*see graph below for an illustration of decreased health expenditures
Compulsory insurance
through National Health
System, established in 1981
Voluntary private healthcare
system (about 15% of
population participates)
130 public hospitals, 13
military hospitals, 2
university hospitals
200 Primary Care Health
Centers
NHS is paid for mostly by
taxes
Examples of specific impacts of austerity measures
 Hospitals and doctors offices are without basic medical supplies such as gauze, band-aids, and
syringes, and are turning to cheaper equipment in order to cut down costs
 Cancer screening programs have been drastically reduced
 HIV and tuberculosis rates are rising*
 Rates of depression and suicide are increasing
 Malaria is making a comeback due to government’s inability to afford the appropriate pesticides
 Public hospitals are being overloaded, partly because people can no longer afford primary care
Testimonials from clinicians and patients
These quotes come from individuals interviewed by a Greek film maker Aris Chatzistefanou in a short documentary for The Guardian. These people
either work for or are patients at Nikaia hospital, located roughly where the purple star is on the map above. All images are taken from the
documentary, which is cited in the references. Quotes are written on the image of the person who said them.
“Yesterday morning the deputy
governor of the hospital released an
official document. He instructed a halt
to regular surgeries, as of today,
Wednesday the 13th of June. Recently
we also had alarming signs of danger,
signs of financial asphyxiation, from
other large and smaller hospitals across
the country. Doctors and nurses are
buying band aids themselves, to have
one available in their pocket.”
Graffiti on building in Patras, Greece, in response to the austerity measures
imposed in 2010 and made harsher since.
Translated to English: No pain is enough.
References
“I didn’t think these things would
happen in a developed European
country with a developed public
health system. In general,
diseases are now increasing and
getting more serious. This is due
to the rise of social inequalities
and the rise of poverty.”
1. Alfred, Charlotte. "The Deadly Cost Of Austerity On Greece's Health Care System." The Huffington Post. TheHuffingtonPost.com, 3 July 2015. Web.
2. HealthManagement.org. "An Overview of the Healthcare System in Greece." HealthManagement. N.p., 10 Oct. 2010. Web.
3. Aldhous, Peter. "These 6 Charts Show What Austerity Did To Greeks' Health." BuzzFeed. N.p., 6 July 2015. Web.
4. Chatzistefanou, Aris. "Greece's Biggest Hospital Struggles as Austerity Cuts Bite - Video." The Guardian. Guardian News and Media, 15 June 2012. Web.
“I came back to Greece two
years ago. They are now so
vulgar that they give state
benefits only when the levels
of CD4 drop below 200. That
is when you are in the final
stage. Otherwise, you don’t
get the benefit. Some friends
told me ‘I will stop my
medicine in order to drop
below 200.’ We have to do it
in order to survive, to have
something to eat.”
”Most people in the waiting room should
have been treated in primary care.
Since this is not available, they come to
the hospital, where it is also cheaper…
Currently there is a lack of various
materials. Some days there are no
syringes. The next day there are
syringes but there are no gloves. You
start to work without knowing what you
have and what you don’t have.”
 Months-long wait time for appointments and procedures
 Drug shortages and increased drug costs
 Some pharmacists and hospitals are asking for cash payments for fear of not being reimbursed
promptly by insurance companies
 Patient fees have been instituted at many public clinics and hospitals
 Hospitals are understaffed and clinicians are overworked
*see graph below
Two manifestations of public health changes: cut costs
and increased HIV rates
Per-person health spending
HIV infections