The greatest burden is borne by the poor
A recent study by the WHO, carried out in Greece by the Health Economics department of the ESDY, found that people on the lowest incomes were those who paid proportionally the most for health services. Kyriopoulos said this was chiefly due to large amounts spent on private healthcare, direct payment and overcharging, which were in the order of 3.9 percent of the GDP and 43 percent of total outlay on health. Private fees were disproportionate to the households’ ability to pay. In many sectors of the health system, such as biomedicine, demand has outstripped supply, leading to delays, difficulty of access and phenomena such as direct payments to the private sector and paying under the table in both the private and public sectors. «There are two major problems here,» he added. «One is the organization and reconstruction of the health sector – where efforts are being made – and the second is the funding of health services from the state budget and health insurance.» As to whether the real problem was not a lack of funding but poor management, Kyriopoulos said that in fact Greece’s total spending on health was over 9 percent of the GDP, slightly above the OECD average. However, a closer look showed that public spending was just over 5 percent of the GDP (35-50 percent below the average in other European countries), while the private sector accounted for three times as much. «Primary healthcare and the treatment of the chronically ill is poor, but in hospitals and in high-technology sectors resources are wasted,» he said. Evangelismos and other tertiary healthcare units will either have to change the way they are administered or cut staff by 25 percent. «On the whole,» said Kyriopoulos, «Greece is 14th out of 191 health systems with respect to the effective use of resources. Of course, that is not the result of good management but of spending by households, a considerable obstacle to curbing expenditure.»
