Rise in user fees in Greece could reduce access to healthcare, charity warns
BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d200 (Published 11 January 2011) Cite this as: BMJ 2011;342:d200All rapid responses
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Dear Editors,
The condition of the public Greek healthcare system is rapidly deteriorating following the Country’s economic failure.
Greeks skip prescriptions or self-medicate because they do not have money to pay their minimal participation to pharmacists or doctors. [4]
State Hospitals turn away parturient women without job or insurance and small income if they can’t pay in advance. [6]
Greek patients visit free NGO street clinics that were set for illegal immigrants. [7][8]
Doctors working in public Hospitals report that health services are collapsing. [5][13]
Greek Health Minister agrees! [14]
Only two in 10 Greek women regularly have a Pap test, or cervical smear. [3]
Greek schools are faced with malnourished children that faint in class. [1][2]
References
[1] http://www.athensnews.gr/portal/9/51626
[2] http://www.athensnews.gr/portal/14/51149
[3] http://www.ekathimerini.com/4dcgi/_w_articles_wsite1_1_09/12/2011_418041
[4] http://www.ekathimerini.com/4dcgi/_w_articles_wsite1_31623_28/11/2011_41...
[5] http://www.ekathimerini.com/4dcgi/_w_articles_wsite1_1_05/12/2011_417524
[6] http://www.allvoices.com/contributed-news/11039263-greeces-public-hospit...
[7] http://greece.greekreporter.com/2011/11/22/rise-in-patients-visiting-doc...
[8] http://www.ekathimerini.com/4dcgi/_w_articles_wsite1_1_22/11/2011_415837
[9] http://www.guardian.co.uk/world/2011/aug/05/greece-healthcare-brink-cata...
[10] http://www.bbc.co.uk/news/health-15220054
[11] doi:10.1016/S0140-6736(11)61556-0
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61556-0/fulltext
[12] doi:10.1016/S0140-6736(11)61152-5
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61152-5/fulltext
[13] Overburdened public hospitals are facing acute shortages of everything from syringes to bandages because of budget cuts:
http://www.washingtonpost.com/world/in-greece-fears-that-austerity-is-ki...
[14] Greek National Health System will collapse within months, says Health Minister:
http://www.ekathimerini.com/4dcgi/_w_articles_wsite1_6625_27/01/2012_424775
Competing interests: Dr Stavros Saripanidis is a diligent taxpayer who continues to pay for all the accumulated debt of Greek public hospitals, which continues to grow, despite all harsh austerity measures!
No time or money to reform Greek healthcare system: only solution to scrap and rebuild it from zero.
Dear Editor,
We read: tragedy, shortages of medical supplies, bribes, long waiting
times, understaffing, suicides rose by 40%, new HIV infections rose by
52%, patient deliberate HIV self-infection to obtain access to State
benefits or faster admission onto drug substitution programmes, tens of
thousands of Greeks seeking medical attention from NGO street clinics[1],
600 Greek medical doctors serving as volunteers in Africa return to help
patients in their crisis-hit Country, NGO food containers programmed to be
sent to Africa to be distributed in Greece[3], primary school pupils
fainting in class from starvation[4], State money lasting only for another
15 days [10] [11] [12] [13], waiting for European Community/International
Monetary Fund/European Central Bank combined rescue loan to survive,
technical default to last for weeks[5], in the study The Lancet
published[1] [2], and other news agency reports.
On the other hand, Greek public hospitals continue to produce every
year debt exceeding their total market value [6] and Greece continues to
be by far the first European Country in pharmaceutical expenditure per
capita [7] [8] [9]!
It is clear that the situation has reached breaking-point.
There is no time or money to plan long-term healthcare reforms.
Immediate action must be taken.
Since the existing healthcare system has been proven inefficient,
corrupted and extremely expensive, Ministry officials should scrap it and
build a new one, from zero.
References
[1] doi:10.1016/S0140-6736(11)61556-0
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61556-
0/fulltext
[2] doi:10.1016/S0140-6736(11)61152-5
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61152-
5/fulltext
[3]
http://www.ekathimerini.com/4dcgi/_w_articles_wsite1_1_26/10/2011_412073
[4] http://greece.greekreporter.com/2011/10/13/greek-crisis-out-of-
control-primary-school-pupils-faint-from-starvation/
[5]
http://www.ekathimerini.com/4dcgi/_w_articles_wsite2_1_28/10/2011_412281
[6] Stavros Saripanidis' Rapid Response in:
http://www.bmj.com/content/343/bmj.d4870.extract/reply#bmj_el_268394
[7] Stavros Saripanidis' Rapid Response in:
http://www.bmj.com/content/343/bmj.d4803.extract/reply#bmj_el_270274
[8] http://www.onmedica.com/newsArticle.aspx?id=098f821c-94bb-4acf-
ac08-e663361e74ed
[9] http://www.cmaj.ca/content/183/9/E523.full.pdf
[10] http://www.newser.com/article/d9q5k3ko0/finance-minister-says-
greece-can-last-until-mid-november-without-next-batch-of-bailout-
loans.html
[11] http://marginalevolution.com/blog/archives/1511/
[12] http://www.rte.ie/news/2011/1004/greece-business.html
[13] http://tv.ibtimes.com/djia-stocks-up-following-comments-by-
bernanke-greece-to-run-out-of-money-by-mid-november-christie-sa/2101.html
Competing interests: No competing interests
Rather than try to renegotiate payment to medical professionals,
Greece has an ideal opportunity to become the first European State to
alter what has been an unreasonable and inequitable longstanding
relationship where the taxpayer funds the executive arm of the private
pharmaceutical industry rather than the latter funding it's own
professionals. I cannot think of any other industry whose products are
monopolised, marketed and distributed by self-employed professionals where
the latter are paid solely from the public purse.
Not only would this measure ensure that doctors are funded by the
corporations which employ and vest them in their services, but also the
public would begin to understand that vested interest long existing
between the pharmaceutical industry and medical physicians and become more
capable of making the right choices in seeking medical, complementary
medical and alternative medical care.
Competing interests: No competing interests
Dear Editor,
Severe economic crisis in Greece together with decades of bad public
fund management have depleted available resources for healthcare.[1] [2]
[4]
GPs and Consultants are obligated to visit 2,000 different patients
each month in order to receive a net salary of 2,000 euro. [5] [6] [7]
This means 1 euro for every patient examined!
Swiftly processing 2,000 ultrasound examinations or 2,000 ECGs or
2,000 Fine Needle Aspiration biopsies each month is unethical, but this
does not seem to bother Insurance Finance Departments.
Doctors will be forced to require extra private payments, directly
from patients, if they are to sustain acceptable standards of care and pay
taxes and bills of their Surgery or Medical Office.
Can impoverished Greeks afford to pay extra to visit their GP?
No, they can't.
Up to now user fees in Greek Public Hospitals were bypassed by
strikes, solidarity movements, etc
In fact, Hospitals in Greece produce annually debt exceeding their
total market value! [3]
How can GP salaries be bypassed?
I am afraid they can't.
We are about to witness women dangerously missing their Pap tests,
their mammography scans, their obstetric visits, their post-partum
examinations, etc
Tertiary Public Hospitals, on the other hand, will be flooded and
paralyzed by emergency or presumed emergency arrivals, which remain free
of charge.
Free of charge, but still accumulating debt...
References
[3] Stavros Saripanidis' Rapid Response in:
http://www.bmj.com/content/343/bmj.d4870.extract/reply#bmj_el_268394
[1] BMC Health Serv Res. 2005 May 28;5:41.
Organisation and financing of the health care systems of Bulgaria and
Greece -- what are the parallels?
Exadaktylos NM.
Higher Technological Educational Institute of Thessaloniki (A.T.E.I.T.),
Vasilis Olgas 6, 54640, Thessaloniki, Greece.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1156891/?tool=pubmed
[2] Health Syst Transit. 2010 Nov;12(7):1-177.
Greece health system review.
Economou C.
Panteion University of Social and Political Sciences.
http://www.ncbi.nlm.nih.gov/pubmed/21330233
[4] Health Econ. 2005 Sep;14(Suppl 1):S151-68.
Analysing the Greek health system: a tale of fragmentation and inertia.
Mossialos E, Allin S, Davaki K.
London School of Economics and Political Science, LSE Health and Social
Care, UK.
http://www.ncbi.nlm.nih.gov/pubmed/16161195
[5] http://www.athensnews.gr/portal/9/47018
[6] http://www.minfin.gr/content-
api/f/binaryChannel/minfin/datastore/4b/4e/d5/4b4ed519772d6460d0b1b1fb2b17091c483a93a3/application/pdf/Quarterly+Report+May+2011
-FINAL.pdf
[7]
http://www.ekathimerini.com/4Dcgi/4dcgi/_w_articles_wsite1_7_31/08/2011_...
Competing interests: Mr Stavros Saripanidis works in private healthcare facilities in Greece and posesses a private surgery.
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Re: Rise in user fees in Greece could reduce access to healthcare, charity warns
Dear Editors,
I am reporting here some recent headlines from Greek newspapers.
All Athens’ Children’s Public Hospitals demand directly from patients 30,000 euro in advance in order to perform vital transplantations: State money is not enough.
Hospitalized patients in the Public Sector are asked to bring their own pharmaceuticals, since there aren’t any left in Hospital Pharmacies: suppliers stopped providing pharmaceuticals on credit because Public Hospitals already owe them billions.
Overstressed nurses in Public Hospitals faint while on duty.
Breast Cancer Women’s Charity “Alma Zois” reports extreme shortages in basic oncological drugs in Public Hospitals.
Entire Regions in rural Greece are left without Specialty doctors: State wages are too low to attract them.
Hospital doctors started to demand gold coins and not cash for informal payments: cash can be traced by police forces…
Ambulance employees for years have been systematically filling their family vehicles with gasoline that was charged to their Hospital ambulance.
In only one year, controls have discovered 700,000,000 euro worth of fake prescriptions.
Despite extreme austerity measures and constant IMF-EU-ECB supervision, Public Hospitals in Greece continue to accumulate debt! [1]
Widespread corruption should be addressed effectively.
Reference
[1] Greek Hospitals produce every year debt exceeding Hospital total market value, Stavros Saripanidis’ Rapid Response in:
http://www.bmj.com/content/343/bmj.d4870?tab=responses
Competing interests: Dr Stavros Saripanidis is a diligent taxpayer who is called to pay for Hospital expenditures but his money evidently finances widespread corruption.