The difficulties of Greek households (and especially low-income households) in accessing the necessary medical care are mainly due to financial insolvency.
Despite significant increases in health spending prior to the crisis, the goal of universal health care remained elusive in Greece, while it was fully achieved in countries such as Spain. Several factors contributed to this:
- (Self-)limitation of state provision of hospital care and de facto privatization of primary health care.
- Distribution of unethical practices (for example, “envelope”, bribe) in public hospitals.
- The decline in the prestige of public hospitals and the transition of the middle class to the private sector.
- Low percentage of private insurance.
Nor creation ΕΣΥ in 1983, nor periodic reforms in the following four decades have been able to significantly change these basic facts. The result has been an undue burden of health care costs for Greek families..
During the crisis, the situation worsened. Public spending on health has declined significantly (by 46% at constant prices over the period 2009-2014). While this reduction is partly due to a reduction in previous waste and mismanagement, it has in part led to a reduction in government provision of vital services. As a result the number of those who were denied needed assistance because they could not cover its costs tripled (from 4% of the population in 2009 to 12% in 2016), and the participation of patients in paying for medical services has increased (from 29% of total costs in 2009 to 35% in 2015).
As the OECD chart shows, Greece has the third highest burden of spending on family health in EU. Only Bulgaria (37.8%) and Latvia (35.6%) have a higher proportion of patients’ out-of-pocket health care expenditures. The pandemic has further increased the burden of healthcare costs on Greek families. At the same time, it makes even more tangible the value of access to health care and the even more pressing need to strengthen public provision of essential health services.