[Homestead] What do the most prosperous states in Europe have in common.
tvoivozd at infionline.net
Sat Sep 4 23:45:52 EDT 2004
Universal National Healthcare---all the Scandinavian states, Britain,
Germany France, all the way to Mediterranean Greece. which was in dire
poverty at the end of WWII and is now the most prosperous in the
Mediterranean, a miniature melting pot like the U.S., but 14th in health
statistics---what is the level of the U.S., a miserable 42nd?
Greece in Brief
Health and social services
The welfare state in Greece is almost 70 years old and attempts to
create a so-called “safety net” for the whole of the population,
including the sick, disabled and elderly people. The responsibility for
the management of the social insurance system, as well as of the
unemployment and family assistance benefits, belongs to the Ministry of
Labour and Social Insurance.
The system is financed by contributions from employers and employees.
The founding stone of the Greek welfare system was the creation, back in
1934, of IKA (Social Security Institution), which was, and still is, a
vast organization comprising 331 Administrative Centres and 364 Health
Units. All IKA members (more than 5,550,000 including the ones who are
not directly insured) have access to a sufficient standard of health
care as well as a pension, upon their retirement. A second milestone was
the creation, in 1961, of OGA (Agricultural Insurance Organisation),
which covers all the country’s rural population. It is worth noting that
since 1975, the welfare state in Greece has been constitutionally
guaranteed (see Article 24 of the 1975/1986/2001 Constitution).
In the early 1980s, despite economic problems, the welfare state
expanded. In order to reduce the degeneration of the old health care
system as well as to restrain the expansion of private practices, the
ESY (National Health System) was enacted by the first socialist
government of PASOK. The inaugural article of the relative legislation
(law 1397/83), declared that: «the state has a responsibility for
providing health care to all citizens, regardless of their financial,
social or professional status». ESY’s main objectives were the equal
distribution of health services, sufficient coverage of needs,
improvement of quality and emphasis on each region separately.
Most of the aspects of the new system have been spectacular: for
example, the number of hospital beds has increased from about 32,000 in
1983 to more than 52,000 today, while the number of doctors —including
dentists— exceeds 54,000.
As a result, a recent study by the World Health Organization ranked the
Greek health system as 14th out of 191. Encouraging though this figure
was, the Greek government is pushing ahead with major health care
investment, as witnessed in the budget for 2001, in which the sector was
given a considerable boost with an 11.5% increase in health spending.
In addition, in order to solve the problems and malfunctions of the
present welfare state system, the government decided to proceed towards
a restructure of ESY. According to the plan under way, ESY is being
divided into 17 autonomous and independent regional branches, called
PESY (Peripheral Health Systems). Although the cost of PESY development
during the first year of their operation, starting from July 2001, will
exceed the amount of 6.6 billion drachmas, it is expected that in the
long run, the system will save a big amount of money estimated to reach
65 billion drachmas up to 2006.
The quality of services provided is also expected to increase
significantly, therefore discouraging many Greeks from turning into the
private health sector.
By the same token, in order to improve the overall level of medical
services, to provide greater access to health care services and to
manage resources in the health care sector, the Ministry of Health and
Welfare is implementing a number of projects with the aid of information
technology and telecommunications.
However, the increase in life expectancy and the falling fertility rates
pose new challenges in the social insurance system. These developments
progressively affected all the major insurance organizations, decreasing
the standards of the services provided, keeping the amount of pensions
allocated on a low level and, consequently, forcing many Greeks -those
who can afford it- to seek complementary (private) insurance.
As a result, the adoption of a new scheme was deemed to be necessary and
in 2002 a big reform initiative on this issue was presented by the
Ministry of Labour and Social Insurance.
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