Poor pay through the nose

The underfunding of health services by the State and social insurance agencies gives rise to inequalities that affect the poorer sections of society. In Greece, unlike most European countries, the burden of health payments is in inverse proportion to income, according to a study conducted by the Economics of Health Department of the National School of Public Health and University College London for the World Health Organization (WHO). This inequality does not derive so much from contributions and taxation, as from private expenditure on health (what Greeks pay out of their own pockets), which is very high in Greece, amounting to 42 percent of total expenditure on health. And a disproportionate amount of that comes from those with the lowest incomes. What this means in practice is that people are insured for only 58 percent of their needs. For the remaining 42 percent they pay directly, for doctors’ visits, tests, medicine and so on. The WHO study on justice in the distribution of health service funding puts Greece very low on the list of EU member states. This study shows that the No. 1 problem in health service policy is that of insurance and funding, says Professor of Health Economics Yiannis Kyriopoulos. The lack of funds does not derive from the health service system, but from all the financial problems of the past 20 years and the crisis in social insurance, he explains. Since public and social funds are low, the health system has to draw funds directly from households in the form of private expenditure, which gives rise to inequality. Implementing changes in the health system presupposes reform of public finances, social insurance finances and funding for health services. Private expenditure won’t solve health policy problems, because there is a fiscal and social insurance crisis, says Kyriopoulos. Symbolism for a tough world

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