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Wednesday, April 17, 2013

The proposal of the Metropolitan Community Clinic at Helliniko for the uninsured citizens





The text below was prepared by Metropolitan Community Clinic at Helliniko in December 2012 and is our entire proposal pertaining to uninsured patients.  We call upon all community clinics in Greece and all citizens to support it.

"NO ONE ALONE IN THE CRISIS"

A PROPOSAL BY THE VOLUNTEER COMMUNITY CLINICS FOR THE UNINSURED

A national public health system which uses insurance as the only criterion for a patient to be served is, by definition, a failure.  It is inhuman in a country where unemployment is close to 30% and where undocumented immigrants number about one million.  A health system which serves only the insured citizens and leaves about 1/3 of its people without care gravely endangers public health.

Five years ago, when there were far fewer unemployed and almost everyone was insured, Greece spent more money on private medical care than any other country with a national health system.

Today, the economic crisis has up-rooted everything; high unemployment, illegal labour practices and severe under-employment are rampant. We believe that to achieve the goal of a universal access to public health (a principle which is at the very heart of the Greece’s NHS), the Greek National Health Service requires radical change in how it is financed, and also in how citizens have access to it.  These changes must be interlinked with new policies concerning labour, taxes and immigration.  It is obvious that until such changes are firmly established, that more than one third of the population cannot wait to have access to the health system.

The lack of a viable public health policy for the uninsured creates serious, irreversible health issues in patients with devastating diseases, exposes the entire population of the country and its visitors to infectious and contagious diseases and invalidates the constitutionally established right of equal access to health care.

But most importantly it promotes a negative reality in our society, a reality not consistent with the principles and values of humanity, culture, dignity, justice, equality and the principles of the Universal Declaration of Human Rights and children's rights.

The economic policy of the last few years has led to continued economic weakness and a critical mass of unemployed.  Thousands of patients are unemployed and find it impossible to pay private and business debts or pay into insurance funds.  The result is that this "epidemic" of uninsured people is reaching uncontrollable and dangerous dimensions.

The Community Clinics were born from the National Health System’s exclusion of the uninsured, unemployed and homeless.  The Community Clinics can not nor should they try to completely fill in the increasingly enormous and dangerous chasm in public health.  On the other hand, we are not about to abandon our patients; we will not give up on a third of the population.  

The Community Clinics serve patients with chronic health problems who have no access to either the public or private health system.  We are primary care facilities, providing health care and medicines to our patients.  We work together with hospitals, private clinics and laboratories in the community.  

The clinics also carry out drug collection drives, collecting donated drugs, recording and categorizing them, and then making them available to the other community clinics and hospitals.  The medicines are valued and made available to the hospitals after being accepted by the hospital’s governing board.  The commercial value of medicines and materials made available to the hospitals averages, and sometimes exceeds 80,000 euros in a small county.

These volunteer clinics are providing primary care and supporting an ever-increasing tide of uninsured adults and children.  Over the last two years the numbers of people resorting to the clinics has increased so drastically that the clinics are hard-pressed to cope.  The health of the individual and public health is severely threatened.

Given the above, we propose the following:

• Complete hospital coverage of the uninsured, in emergency situations and in the Emergency Department, for the entire length of the hospital stay and, if needed, clinical exams inside and away from the hospital.  These services, while theoretically available under the law, are not provided in practice.    

• Free hospitalization for emergency surgery and stays in the Intensive Care Unit

• Complete maternity coverage including medicines, pre natal monitoring, coverage of the birth, whether caesarean or normal, and hospitalization in the neo-natal unit, as required

• Complete care, for children and minors, including required laboratory testing and medications.

• A free and complete program of vaccinations to be the responsibility of the Center of Disease Control and Prevention of the Greek Ministry of Health.

• Free hospitalization and medication for both inpatient and outpatient treatment for those suffering from infectious and contagious diseases.

• Deletion of past debts of individuals to insurance funds, the continuation of hospitalization coverage during the whole period of unemployment or at least for a period of three years.  The unemployed are to be issued with a special health book.  Hospitals should provide pharmaceutical coverage of beneficiaries from their pharmacies as well as clinical exams.  

• Free access to the medical outpatient clinic of the hospital for the chronically ill from severe and life-threatening diseases conditions.  These would include heart disease, diabetes mellitus, hypertension, malignancy, chronic renal failure, haemodialysis, peritoneal dialysis, psychosis, Alzheimer’s, genetic diseases, and those suffering cognitive and motor deprivation.  Chemotherapy should be offered to cancer patients without charge.  

• A brochure should be made available in all hospitals, fully describing the conditions attached to the special health booklet. 

We reiterate a long-standing demand for a radical reorganization of the Greek National Health Service.  Currently, in this time of cutbacks, neither our insured fellow citizens nor the uninsured, are receiving anything close to adequate health care.

The volunteer Community Clinics will continue to provide primary health care and to collect medications and materials for the clinics and hospitals.  In cases where a local community clinic receives financial support from the local government or authority, there will be a reckoning at the end of the year of the amount remaining at the hospital of that community available for the uninsured.

The Community Clinics believe that individual and public health is a responsibility of the state and should not be left to volunteers. The major investment of a state is its people. They are the capital. A population in good health is the interest and bond yields.  When those people can maintain a decent life, have access to health and education, then the foundations are laid for development, self-sufficiency, and independence and corruption will be discouraged.
         

Volunteer Community Clinics

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