August 18, 2015, by paxsk3
Pills and Pensions: Healthcare During the Greek Financial Crisis
Intense Financial Meltdown
Unless you’ve been able to avoid all print and broadcast media over the summer, terms like ‘bailout’, ‘GDP’ and ‘austerity’ as well as organisations such as the IMF, ECB and Syriza have become synonymous with the intense financial meltdown in southern Europe. Depending on where you stand politically, it is likely your opinion on the subject of Greece has been chosen for you. The left bemoans the tragedy of the forced oppression of neoliberalism on the Greek people. In the centre Greece is regarded as merely not adhering to the rules of the club that it desperately wanted to join, and on the right, the crisis is a stick with which to beat the European Union. All this high-brow intellectual and ideological posturing however doesn’t quite cut to the heart of the issue and actually hints at what we already know: nobody really understands the ‘Greek problem’. This may appear an overly politicized and tangential subject for a pharmacy department blog, but it’s ramifications for healthcare make it highly relevant for the discipline. For a poorly understood crisis, it is a lot easier to think of the issue in ways we can understand; shared experiences. Healthcare is a service taken for granted in the UK but all understand its importance and given its similarities with the NHS it is a useful starting point to make comparison.
The Greek healthcare system in 2007 was rated by the World Health Organisation as one of the finest in the world, with the cost being amongst the lowest in the entire European Union. The state owned Social Insurance Institute (IKA) insures working people and employers pay into this insurance organisation. This differs from the method of general taxation in the UK despite the systems both being under public ownership. Since then, with skyrocketing unemployment and debt, combined with the fact that health insurance is cut off after one year out of work, the ramifications for the ease of accessibility of healthcare for the average citizen are great. Private healthcare is only an ephemeral stop-gap.
The London based GP, Louise Irvine, described the travails of healthcare workers in an article for Open Democracy: ‘The situation is worse than in many developing countries’. She reported that 2.5 million now live without healthcare insurance, 25% of the population which is double that of the United States, considered to be the west’s great healthcare basket case. Suicide is up 45%. Poor access to birth control is having a knock on effect with 300,000 abortions now taking place every year. The latter statistic should demonstrate the current state of desperation given that 98% of the population is orthodox Christian which ideologically prohibits this practice. Cancer screening has been reduced which means early markers are not being picked up. Obesity and malnourishment are also on the rise.
Brain drain
The rate of the population leaving Greece is averaging 80,000 per year from 2012, leading to a brain drain of medical professionals. Hospitals have had their budgets slashed so can’t afford to take on newly graduated doctors so many have no choice but to emigrate. The consultants that do stay are cripplingly overworked and earn only €12k per annum. Consultants are working ten hour shifts five days a week and are on call 24 hours regularly. Greek hospitals now only accept patients on ‘Emergency Days’ which occur 2/3 days a week. On other days, people have to make the trip to hospitals much further away.
The stunting of pension allowances has meant many elderly patients are no longer able to afford their prescriptions, racking up large tabs with their local pharmacists. A draconian law was put through parliament in January allowing the state to seize control of property from citizens that are in a certain threshold of debt. Many are refusing further rounds of treatment, surgical or pharmaceutical, in order to maintain ownership of their family homes. International pharmaceutical companies are believed to be owed €1.1 billion by Greek hospitals and the IKA according to the EFPIA. Some have received no payment since December.
Austerity measures
The austerity measures being imposed on Greece by its creditors and the Greek government itself have been described as human rights violations. Elena Crespi, the Western Europe programme officer for the International Federation for Human Rights said to the International Business Times: ‘The most evident impact has been on economic and social rights, in particular the right to health and the right to work, which have been eroded’. Alexis Tsipras the ruling socialist prime minister commented in April: ‘The targets and conditions the Troika (IMF, ECB, EU) set upon Greece made it impossible to respect human rights. Both Greece and its creditors did not respect human rights.’
In the worst of times however the most extraordinary acts of generosity occur. Whilst obviously struggling to meet the increased demand, social solidarity health clinics have been set up, staffed by volunteer doctors, nurses and pharmacists aim to provide basic healthcare to those who no longer have access to it. An initiative by one of these was to appeal to people to donate a day’s chemotherapy to those in a worse financial situation. More is needed at the macro political level to help the system reach a semblance of normality.
At point of writing, a third bailout agreement has been agreed by the European Parliament. This may provide some respite for the country from its debtors but doesn’t provide any sort of safeguard for its suffocating public services. At a time where we in the UK are discussing the future of our own health service, the situation in Greece serves as a warning for us to not be credulous in face of top-down ‘restructuring’.
Stephen Kenny
About the Blogger
Stephen Kenny is a third year PhD Student based in Boots Science Building. After completing a degree in biochemistry he moved into the field of nanoscience and never looked back.
Thanks for this post. Just to top it all of – the situation is such that even patients with social insurance etc are often refused expensive medicines (anticancer etc) because pharmacists are afraid that the state won’t re-reimburse them for the prescriptions… it has happened not only once in the past… (this is assuming that the pharmacy stocks these medicines in the first place – which nowadays cannot be taken for granted)! it’s sad…