Greek Debt Crisis Creating a Potential Healthcare Disaster

Greece, which used to boast an extensive public health care system with close to universal coverage, has been facing pressure during the past several years from creditors to engage in dramatic savings to cut back the deficit. These measures are also taking their toll on the healthcare system, which also has to deal with the growing numbers of poor and unemployed Greek citizens who cannot afford the new fees and copayment schemes instituted at public hospitals as part of a far-reaching austerity drive.

The Greek government has cut spending on health care from USD 19.5 billion to USD 17 billion, a 13% decrease in just two years. At the same time, public health facilities have seen a 25%-30% increase in patients, since many Greeks can no longer afford private healthcare. According to data published in 2010, private sources used to finance 39.7% of overall health expenditure in Greece, compared with the Organization for Economic Cooperation and Development (OECD; Paris, France; www.oecd.org) country average of 28.4%, forcing a crippling expenditure on the government as a result of the economic crisis.

One of the consequences of this drastic expenditure restriction is that public hospitals are facing shortages of supplies, from toilet paper to catheters to syringes; medical equipment goes unrepaired and is no longer in use; nurses are handling four times the patient load they should since a hiring freeze has been imposed, and waiting times for surgery as a result have become increasingly longer. In addition to shortages, the supplies are of poorer quality, with insects found in syringes imported from China, sutures that fall apart, or inefficient generic drugs.

A similar result of the debt crisis is the sharp price cut on pharmaceuticals. The Greek public healthcare system will only cover prescription of drugs, which are included in an approved list, and for approved indications. The stringent cost-containment is set to remodel the pharmaceutical landscape in a country where generics penetration has always been low. A further setback is that several drug manufacturers have found themselves facing mounting customer debt, and are no longer willing to supply Greek hospitals. They are also unwilling to wait for government reimbursement, and are sells costly drugs, such as those for cancer treatment, on a cash basis.

“Overall, the picture of health in Greece is concerning,” wrote a group of medical researchers in a letter to the Lancet published on October 22, 2011. “It reminds us that, in an effort to finance debts, ordinary people are paying the ultimate price: losing access to care and preventive services, facing higher risks of HIV and sexually transmitted diseases, and in the worst cases losing their lives. Greater attention to health and health-care access is needed to ensure that the Greek crisis does not undermine the ultimate source of the country's wealth—its people.”

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Organization for Economic Co-operation and Development