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Saturday, July 19, 2014

Has a Solution Arrived for the Uninsured?

"The exclusion of the uninsured from the public hospitals, kills" reads the banner

Press Release
Has a Solution Arrived for the Uninsured?

At last, after six years of economic austerity and four years of policies of the “memorandum” which has left the uninsured increasing excluded from the Greek public health system, it looks as if the government may be considering carrying out their constitutional obligations.  Could it be that the timing for this decision is connected with the soon-to-be-released tranche of funds to the country?  Another thing worth pondering is the persistence of some (journalists and politicians) in repeating that assistance for the uninsured is an obligation under the memorandum agreement.  This same Greek government together with the “Troika” decreed austerity measures in May 2010 without any planning or study as to what the results would have on society.  Now with new regulations enacted (Government Gazette 1465 of 05/06/2014 and 1753 of 28/06/2014) they hope to put out the fires that they ignited.

Specifically, under GG1465, uninsured Greeks and non-Greeks legally residing in the country will have hospital care without cost.  We certainly consider this a step in the right direction.  The main obstacle to this is the already dramatically reduced budgets for Greek public hospitals, which will be asked to cover the costs of the extended care.  We have seen a lot of cases of INSURED, but indigent patients who cannot find the medications needed for treatment and troll from hospital to hospital to try and locate them.  Recently, KAT hospital, one of the largest in the greater Athens area, announced it would stop performing surgery, because they don’t have the budget to cover the expenses involved.  These are problems that need SOLUTIONS.  We reckon that the three-member committee that will be appointed to look into these issues, will have a huge job.  Official sources number uninsured citizens at 3,000,000.  How can they be assisted without serious problems and huge delays?

Government Gazette 1753 of 28/06/2014 covers pharmaceutical needs of uninsured Greeks and foreigners legally resident in Greece who can pay the same contribution as those insured.  Expensive medications (and only expensive medications) will be provided without cost, which we feel is a positive step.

The thing that we wonder about here – and this comes from long experience - is that many of the long term unemployed will find it impossible to contribute in any way to payments.  Indeed, with the last modifications to regulations, the Greek Health Ministry increased the co-pays, which creates problems for many of the low-income insured.  Unfortunately, we have many examples of insured citizens who don’t have the means to pay into insurance plans.  So we have to find a mechanism under which those who cannot pay can at least have access to their medication.

But at any rate, with the regulations cited above, along with the ability of public health clinics to admit uninsured patients, at least some uninsured are coming back in the Greek public health system.  Those needs that are not covered are, specifically:

1)      There is a cap of 340 million Euros for medication for all uninsured.  If more is needed, what happens?  
2)      There is no mention in either of the government gazette entries of lab tests, blood tests, MRI, X-Rays etc. for outpatients visiting public health clinics and not admitted to hospital.  What happens in these cases?
3)      Immigrants who are not legally documented where do they go?  Without any recourse to health care, they could be a public health bomb waiting to explode.  What do they do?  A solution should be found for them, perhaps utilizing funds from the EU.
The measures enacted for the uninsured are, without question, a step in the right direction but fall short of full and free access to the Greek public health system.  The big challenge for the Greek government is to focus on proper funding and staffing of the public health system, putting a stop to “creative accounting” practices, and to put a halt to the degradation of the health services while managing funds rationally.  And to do this without social/solidarity clinics, NGO’s funded by the European Union through the National Strategic Reference Framework.  These funds could go directly to strengthen the Greek public health system and cover all the needs of the uninsured.

The Greek public health service is opening up, at least partially, to the uninsured.  They can now access primary care (through the system’s public health clinics) and secondary level care through access to public hospitals and at least some access to medications.  This has been a partial vindication of the gargantuan struggle undertaken by the volunteer community clinics and pharmacies from all over Greece – a struggle lasting three years, constantly pressuring for policies to make access to public health more inclusive rather than exclusive.  The volunteers of the various social solidarity clinics feel we were able to at least partially reverse some of the disastrous policies enacted during the economic crisis. 

The pressure will continue.  We have never been afraid to “speak truth to power.”  Our goal is to see a Greek public health system that is open to all including the most vulnerable groups.  We want to correct the wrongs that lead to an impoverished society. 


Below is a spot from the German “Spiegel TV” which discusses the policies of the past 4 years and shows MCCH.  It is in German with Greek subtitles.

https://www.youtube.com/watch?v=UYzRGpZgNeE








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