[Homestead] What do the most prosperous states in Europe have in common.

Tvoivozhd 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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