ATHENS — Healthcare in Greece risks becoming a privilege after two years of sweeping budget cuts imposed by the authorities in their desperate effort to slash bills and steady the finances, experts warn.
With public health spending at around 10 billion euros, 25 percent lower than in 2009, staying healthy "risks becoming a privilege," says Haralambos Economou, a sociology professor at Panteion University in Athens.
Two years of biting austerity have left Greece in a fifth year of recession with over a million people officially unemployed, some 20 percent of the workforce.
Healthcare experts argue that up to 10 percent of the population now has to dig into their dwindling savings if they need treatment.
Previously, most Greeks had turned to private care whenever possible, even to the tune of paying nearly 40 percent of total health costs out of their own pocket, one of the highest rates among developed nations.
Now, demand at public hospitals is up 20-30 percent as they fall back on the state system just as it comes under intense pressure from the cost cutting.
Worse still, many people seek to finesse the system, turning up at hospital as an emergency case in order to get immediate treatment, rather than arrange -- and have to pay for -- an appointment in advance.
The hospitals try their best in the circumstances.
"After recent reforms forced us to take money from people who lack healthcare coverage, more and more patients try to avoid making appointments for lack of cash," says Meropi Manteou, a lung specialist at Sotiria general hospital in Athens.
"They come in with the flu and try to pass it off as an emergency. We do what we can to help the poorest that come but I don't know how long we'll be able to turn a blind eye," Manteou said.
Even those with years of healthcare contributions behind them face increasing problems.
The health ministry has cut the list of medicines and tests eligible for a partial refund from social insurance funds, which are themselves in dire straits from fiscal mismanagement and chronically low contributions now exacerbated by the rising rate of unemployment.
State hospitals are having to make do with reduced funding, doctor salaries cut by a quarter, a chronic shortage of nurses and overtime pay pending since December, grumbles George Kalliabetsos, a pathology clinic supervisor in the central city of Volos.
Kalliabetsos says his clinic frequently has to accommodate 45 patients with only 35 beds, four doctors out of a required seven and just two night nurses, not to mention regular shortages in medical supplies.
Health ministry officials insist the cuts were necessary to rid a system, originally modelled in the 1980s on Britain's National Health Service, of decades of wasteful practice.
"There is great room to cut cost without hampering the system," argues Stavros Karvounis, a financial advisor to Health Minister Andreas Loverdos.
As an example, he notes that medicine costs ultimately borne by the state had skyrocketed before the economic crisis hit Greece in 2010.
The health minister recently charged that Greeks are still overspending on unnecessary medicine and hospital tests, burdening social welfare funds as the country faces its worst debt crisis in decades.
Loverdos said 3.5 million CAT body scans were carried out in Greece last year, double the number in the other European Union states combined while Greeks also threw out one billion euros ($1.3 billion) of out-of-date medicine stored in their homes.
Public spending on medicine also was cut to 3.75 billion euros last year from 5.6 billion euros in 2010, and the health ministry plans to make another 800-million-euros cut this year, Loverdos said.
One of the ministry's proudest achievements this year has been the introduction of a new online prescription system to eliminate the chaotic book-keeping that had allowed unscrupulous doctors and pharmacists to write bogus prescriptions for years, skimming the proceeds.
But the kinks in the new system are such to drive law-abiding doctors mad.
"It's a total shambles; the system is down two or three times a week, and the drugs are listed in a completely irrational manner," says Maria, a general practitioner who declined to give her surname.
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