28 June 2016Helliniko
The Initiatives between MCCH and Europe Continue
On Tuesday, the 28th of June, the leader of the Greens in the European Parliament, Rebecca Harms met with Mr. Alexis Tsipras, the Greek Primer Minister during the meetings of the European Union leaders and the European Parliament. Ms. Harms has repeatedly expressed her support of the beleaguered population of Greece and has repeatedly taken the initiative to make known to the wider world the struggle required survive austerity. She asked us to prepare a letter that she would present to Mr. Tsipras with our suggestions as to what needed to be done in the health sector. She indeed delivered this letter and expressed the wish that Mr. Tsipras would agree to meet with representatives of MCCH as well as other social clinics to discuss all the problems that plague the health sector.
The following is a translation of the letter delivered to the Prime Minister.
Honourable Mr. Prime Minister,
Since 2010 when the first memorandum agreement was implemented, the health system in our country has undergone two basic changes which have steadily led to the tragic outcome that we are experiencing today. The first change is the consistent under-funding of the system and the second is the reduction (in some cases to zero) of medical staff, both doctors and nursing personnel.
Expenditures for health were approximately 7% of GDP in 2009. Today they are 3.5 to 4% of GDP. The average expenditure for other European countries is 7%.
Indicatively, hospital expenses were about two billion Euros in 2012. In 2015 they had fallen to 1.3 billion and to 1.15 billion in 2016.
From 2013 the impact of these budget slashes have led to what can be rightfully called a humanitarian crisis.
1. A rise in infant deaths from 2.7% in 2010 to 4% in 2014.
2. Negative relation of births to deaths from 2011
In 2014 births totalled 92,148, a reduction of 2.1% from 94,134 births in 2013. A reduction of 2.1% in one year!
On the other side of the life-scale, deaths increased 1.17%, totalling 113,740 in 2014 up from 111,794 in 2013.
Eurostat reckons that this negative change in the natural relationship of life to death, will lead to a steady reduction to total population by 2050
3. Increase in morbidity
Acute myocardial infarction has risen from 1.4% in 2009, increased to 2.0% in 2015
Diabetes from 7.9% in 2009 to 9.2% 2015
Depression from 2.6% in 2009 to 4.7% in 2015.
4.The study HELLAS HEALTH VI in 2015 from the Institute of Social and Preventative Medicine reports:
One out of four people who take medication on a regular basis have reduced purchases of daily needs to cover the cost of medication.
One out of every five does not fill prescriptions because of the inability to pay.
5. According to the annual study of Euro Health Consumer Index (ECHI) which analyzes health in 35 countries, based on the 48 health indicators, Greece in 2015 fell to 28th place in 2015, while in 2012 it held 22nd place, in 2013 25th place and 2014, 27th.
The reduction in the budget of hospitals has created serious shortages in both medicines and medical supplies.
The Metropolitan Community Clinic at Helliniko regularly sends medicines and supplies to 4 or 5 public hospitals every month.
The reduction in hiring staff has also contributed to the tragic outcome. And here are but two examples:
- The wait list for ICU in public hospitals is from 20-30 patients – and the result is that lives are lost
- The average wait time for cancer patients for radiation treatment is 4 to 5 months with dramatic results on their health
From the beginning of the cutbacks until 2014 uninsured patients had no access at all to the Greek public health system. In the summer of 2014, the government allowed the uninsured to have access to the public health prescription system with the same co-pays for medication as the insured. The uninsured were also allowed access to hospitalization based on the recommendation of a three member committee. In practice, both of these initiatives failed because many of the uninsured did not have the money even to cover the co-pays and the three member committees never functioned. The law that contained these provisions, did not give the uninsured any access whatsoever to diagnostic tests.
Your government voted about three months ago for a new law which allows for those whose income is under a certain level to have access to medication with no co-pay (this has not yet been implemented). And the new law gives, for the first time, access to these patients to diagnostic tests, although only in public facilities, and has done away with the three member committee, and patients can now claim free hospitalization with only their social security number.
This is a law much better than the previous one although to work in practice it will require generous funding to the public health system to both the public hospitals and the public primary health clinics. We already have examples from patients this is not working in practice and we have these examples at your request.
And with this newer law we continue to have patients in two categories, those who are insured and can access the public health facilities and the private health facilities as well, with a portion of expenses paid, and the uninsured with access only to the public health system. For example for a CT scan, the average wait time for an insured patient is 4 to 5 days while an uninsured patient can expect a 20 to 25 day wait and that is in cities that have working CT machines. What about rural areas where there are no CT scanners or MRI machines?
I could mention many additional examples of the impact of austerity on health and we are always at your disposal for any further information.
What we seek and what we’ve been striving for all these years is to remove the Greek health system from the quagmire of austerity policies. This is what we ask from you. Further, for the Greek government to inform Europe of the tragic situation that that we have all experienced these years of austerity policies with a special emphasis on the need to remove the health system from the “logic” of austerity.
There are forces in the European parliament who can assist in this effort. The President of the Green Euro-parliamentarians, Rebecca Harms has already taken important steps in this direction along with other MEPs.
By honestly facing the effects of these policies which have created a humanitarian crisis in this country and demand, based on international and European justice, to stop austerity in the health sector we can begin to improve the lot of ordinary people. We want to free the health sector from the iron grip of the memorandum agreement.
Only then will uninsured have equal access to the health system, and only then will there be correct and worthwhile reform of the primary health care system. Only then will the increasing mortality and morbidity stop in our country.
Metropolitan Community Clinic, Helliniko
Member of Board of Directors of the Athens Medical Association