The document discusses Greece's national healthcare system challenges including socioeconomic factors, a reduction in public financing leading to a deterioration in quality, and an increased dependence on the private sector. Measures taken to reduce healthcare expenditures, as required by an IMF agreement, focus solely on cost and not quality or outcomes. Key stakeholders like patients were not adequately consulted during negotiations around the measures.

1. Kathi Apostolidis
Breast Cancer & Patient Rights Advocate
Voluntary Sector Consultant-Health Commentator
Engage 2011
Nov 28, 2011, Brussels

2. Health effects of financial crisis:
omens of a Greek tragedy

3. Public Expenditure on Medicines 2004-2010

4. Is the medicines expenditure at
20%
of total healthcare expenditure
the only culprit
for staggering healthcare
expenditure?

5. Healthcare Expenditure as % GDP
(OECD Average & Greece)

6. Challenges of Greek ESY-
National Healthcare System
• Socio-economic & demographic factors
• Reduction of public financing resulting in quality
deterioration of public healthcare sector
• 35 mandatory social insurance funds for healthcare and
pension
• Steady increase of private payments for healthcare
• Increased dependence on private healthcare sector
• Access and disparities problems
• Low satisfaction of patients from public healthcare system
• Excesses & bad practices in medicines prescribing & referrals
• Absence of a central reliable healthcare supply system

7. Situation aggravated by..
• lack of audit, measurement & evaluation of healthcare
services
• lack of modern accounting & MIS in all healthcare system
• no interoperability of systems
• absence of health information technology
• uncontrolled & overpriced purchases of medical equipment
& supplies
• high expenditure on medicines
• no state control in the distribution channels of medicines
• no real price reduction between original & generic
medicines

8. MoU between Greece, IMF, ECT, EU
Requirements
• Reduce & maintain total public healthcare
expenditure lower or equal to 6% of GDP
• Reduce public expenditure of medicines by 2
b. euro till 2012, while 1b. euro should
recovered within 2011
• Public expenditure of medicines = 1% of GDP

9. Measures taken
• Introduction of an e-prescribing & e-referral
app
• Introduction of DRGs
• Establishment of the Prices Observatory for
Healthcare Purchases
But a lot more has not been done or has been
relayed for after the elections for fear of political
cost…..

10. What’s at stake?
Public Healthcare Outcomes!
Measures aimed solely at expenditure
reduction not at quality health outcomes

11. How measures were taken?
After strikes & negotiations with healthcare interest
groups e.g. physicians, pharmacists, pharma,
nurses….
Have the key stakeholders been consulted?
Who are they? PATIENTS of course!!
Patients in Greece ARE NOT
a key healthcare stakeholder

12. THANK YOU FOR YOUR ATTENTION!
Kathi Apostolidis -@kgapo
Breast Cancer & Patient Rights Advocate
Voluntary Sector Consultant-Health Commentator
Engage 2011-Nov 28, 2011, Brussels